For many preparing for their own death, they may not fear dying as much as they fear leaving loved ones behind. While part of this feeling is the odd sensation of “missing” them, they may also mourn that they won’t be able to experience their milestones or provide support when it would be helpful. However, with a plan, it is possible to help a dying loved one remain more present even after they are gone. 

The following are three ideas that allow the dying to provide an aiding presence, even when no longer physically present. 

Idea #1: The Advice Column

Brothers, sisters, parents, and grandparents are all sources of immense wisdom throughout life’s highs and lows. A bit of brotherly, motherly, or grandmotherly advice during a specific time of life can be immensely meaningful, if not even helpful when received at the right moment. For this, it can be very meaningful and even logistically helpful to have a dying person provide input for an occasion in the future. Perhaps it is a bit of relationship advice, parenting advice, or even something as seemingly mundane as financial advice for a grown child. 

How to execute: 

Create a list of possible common hardships or confusing events that may arise in a person’s life. These can range from relationship problems, parenting issues, or any other hardships in which the dying person has some life experience and advice to impart. If they have the strength, they can write down their advice (preferably in their own handwriting, as this can impart a bit more meaning) but also recorded audio or video—both of which can be transcribed by a trusted third party. 

Idea #2: The Life Cycle Celebration

Any passing means that a loved one won’t be physically present to celebrate and offer their congratulations or blessings. Many dying people may prematurely mourn the fact that they won’t live to see a child or grandchild grow up, have a coming-of-age ceremony (bar/bat mitzvah, confirmation, etc.), graduate from a learning institution, get married, have children, or witness their own lifecycles. For this reason, it can be meaningful to create the celebratory offerings that this person would offer as though they had survived to experience such themselves to be offered at the proper time. 

How to execute:

Depending on the state of the dying loved one, it can be meaningful to capture their congratulations or blessing in physical form. This may mean purchasing an array of birthday cards with birthday wishes pertaining to various ages. Perhaps it could be recording video or audio messages in response to various lifecycle events that are to come—weddings, anniversaries, coming-of-age ceremonies, and the like.

Idea #3: The Family Historian

Our loved ones are saturated with stories of our history. They loved to dote on us and recall amusing memories. Even if some of the stories are embellished with time, this makes no difference to most—in fact, that bit of editorial seasoning can make the stories even yummier. But when someone passes, if not recalled properly by those they leave behind, many of their stories go with them. This is why it can be so incredibly meaningful to allow them to account such stories while they’re still able to express them. 

How to execute: 

How a story is told will largely be dependent on the storyteller and those present to capture it. It can be written down in their handwriting for an enjoyable read. They can be captured on video or audio recording. It is recommended to let the storyteller tell the stories they wish to tell the most unprompted, but also to create a form of an interview in order to curate stories they may forget that they possess. For example, one may ask, “Tell me about the first time you saw mom,” “What was the day I was born like?”, “What was your childhood like?” — or other such questions designed to conjure up wonderful and interesting tales. 

An interesting aspect of capturing advice, congratulations, blessings, or stories is that it helps both parties involved—those who are on their way beyond this world and those they leave behind. The advice can bring children and grandchildren immense comfort and cherished advice. On the other side of the coin, the process of capturing these blessings or memories can help the dying feel productive and cherished as well as help them take their minds off any anxieties they may be experiencing. 

The result will likely be a collection of blessings and stories that will remain a priceless collection of media for your friends and family for generations. 

Professional Hospice Care in Tulsa, Oklahoma

If you or a loved one will need or is in need of professional hospice care, look no further than Cura HPC Hospice & Palliative Care.

To-do lists helpful tools for anyone. 

• Weed your garden. 
• Buy more cat food. 
• Sort the mail. 

Fears are important to process. 

• Why you’re stressed about your job. 
• Why you feel disconnected from your children or parents.
• What happens after we die. 

While most people can sort out their goals and fears using a to-do list or a journal, it is important for someone nearing the end of their life to outline their goals and fears while they still can. 

But why? 

The Importance of Outlining Goals

For a person who is nearing the end of life, one of the most common hardships to face, especially if they’re younger, is the feeling that they have not accomplished all of their goals. Though summiting Mount Everest or running a marathon may be out of the realm of feasible possibility for someone with a terminal prognosis, there may be smaller goals that may be possible. These can range from reconnecting with an old friend to wanting to die at home instead of in a hospital. 

Knowing the goals of a dying loved one or having your goals known can provide immense emotional relief and direction when communication becomes more difficult. 

The Importance of Outlining Fears

If goals are what you would like to do or happen, fears are what you wish to avoid. Outlining your fears or getting a dying loved one to outline their fears, though challenging, can be immensely rewarding for all involved. Not only can expressing these fears keep them from becoming bottled up, but it also allows them to be examined clearly. At times, simply expressing a fear is half of the battle of conquering it. Entering the end of life with as few fears as possible can ease the emotional burden not only on the dying individual but for all of those involved. 

How to Outline Goals & Fears

Outlining goals and fears does not have to be complicated. If the person can still write, they may find that writing them down by hand can be immensely cathartic. If they can no longer write, you can choose to simply sit with them and ask them about their goals and fears in a conversational manner, writing them down as you go. You may also choose to record the conversation with audio or video, but make sure to do so with their permission to preserve their trust. Make sure to explain that them outlining their goals and fears is simply a way of getting to know them even better so that you can provide the best care possible. 

Professional Hospice Care in Tulsa, Oklahoma

In the pursuit of extending your options, we’re here to help. If you or a loved one will need or is in need of professional hospice care, look no further than Cura HPC Hospice & Palliative Care.

In the documentary “Being Mortal,” filmmakers followed the case of several individuals with terminal diagnoses. 

One such case was that of Sara Monopoli.

Sara was pregnant with her first child when she was diagnosed with stage 4 lung cancer. She gave birth with collapsed lung because a C-section was too risky. 

Her cancer later spread to her thyroid and elsewhere in her body. Her cancer diagnosis was advanced and terminal. Despite this, she received aggressive treatments in hopes of extending her life. In hindsight, her husband and doctors believe that such treatments, though well-intended, may have actually shortened her life. They undoubtedly deteriorated her quality of life—a concept her husband continues to reflect upon.

“I’ve thought often about—what did that cost us? What did we miss out on? What did we forgo by consistently pursuing treatment after treatment after treatment that made her sicker and sicker and sicker?” 

On the flip side of the coin, another patient in the film, Jeff Shields, an elderly farmer, was diagnosed with advanced lymphoma. As chemotherapy and a bone marrow transplant began to fail, Jeff weighed his options. 

Jeff decided that he didn’t want to die in a hospital. Instead, he wanted to die on his farm. Receiving hospice care in his own bed in a room on his farm, Jeff is captured in the documentary spending time with his friends, children, and grandchildren. 

When interviewed, Jeff seems almost jubilant. 

“The last couple of weeks I’ve been surrounded by family and friends. It’s been terrific. Some of the best days of life, I must say. But then there's a downward trend that's more rapid than I expected. I felt great during that time and my body was in rapid decline. Since then my mind has been in rapid decline. I get confused. But I'm still a happy guy."

Many are faced with the difficult decision to potentially forgo what Jeff called, “a good death” in return for extended life or to forgo a slim chance at living a longer life thanks to potentially harsh treatments.

Though the decision will likely always be one of the most difficult anyone is forced to make, the documentary explores how the culture in medicine has begun to shift away from that of simply attempting to extend life, regardless of its quality, to first and foremost extending the quality of life—however that happens to appear for each patient and their loved ones. 

Professional Hospice Care in Tulsa, Oklahoma

In the pursuit of extending your options, we’re here to help. If you or a loved one will need or is in need of professional hospice care, look no further than Cura HPC Hospice & Palliative Care.

Whether you’re the decision-maker for someone receiving care, the main caretaker, or both, you never quite get used to those moments when a medical professional wants to speak to you about a loved one’s care—or the “hall conversations” as they’re frequently portrayed. Even if your loved one receiving care is also in the room, you may feel all alone and that the weight of the world is on your shoulders. 

In these moments, it is important to take a deep breath and remember a few different truths: 

1. You’re not alone.

As the decision-maker, this comes with a kind of emotional heft that makes it feel as though you’re not only in charge of making choices but also seeing them through. If you’re feeling alone and under immense stress, take a moment to breathe and remember the many people you have on your side. 

There’s a good chance that you have other family and friends willing to help you shoulder the emotional and logistical load of being a deciding caretaker. If friends and family are sparse, you have a team of medical and caretaking professionals who are there to not only treat your loved one but also to make sure you’re thriving as well. In addition to these, there are many support groups—online and physical—with people who know precisely what you’re going through and who are willing to help. 

2. Avoid the temptation to catastrophize any situation.

“We suffer more often in imagination than in reality.” — Seneca

The only way humans have survived as a species is to be on high alert whenever situations become tense. In caveman days, this was how we avoided predators and harmful conditions. These days, we retain much of this mental wiring even when situations are not as dire as we make them out to be. 

As a loved one, there’s a good chance that your mind has quickly jumped to many worst-case scenarios. The doctor’s knock on the door to discuss care may make you jump and your palms sweat. But how frequently do these conversations upend everything? Likely not very frequently. And even if the news isn’t favorable, it is still important to recall that you’re not alone. 

3. Lean into the plan.

For many, most anxieties emerge from not knowing what to do next. It can feel like whenever you hear bad news from medical professionals, they’ll simply toss up their hands and walk away like they might be portrayed as doing in TV and movies—leaving you to spiral into a state of overwhelming confusion. Well, here’s the good news—they won’t. They will present you with your new marching orders. 

Even when the news received in these conversations isn’t favorable, there will always be a corresponding strategy for you to help execute. It can be easy to feel overwhelmed by these plans, but let them give you purpose. Allow them to be your compass or North star. When you feel lost or confused, consult the plan and make sure you’re doing your part. Again, if the plan feels overwhelming for you, remember that you are not alone. 

Professional Hospice Care in Tulsa, Oklahoma

When we say that you’re not alone, we mean it. If you or a loved one will need or is in need of professional hospice care, look no further than Cura HPC Hospice & Palliative Care.

Most of us are likely accustomed to the following hospital scene from any number of TV shows or movies: 

Either a family is gathered around a loved one in a hospital bed or a character is sitting alone in an examination room—all awaiting the arrival of a doctor to deliver the bad news. This “bad news” is typically a terminal diagnosis or news of projected lifespan. In these scenarios, for the sake of drama, doctors are usually fairly blunt—using statements like, “You don’t have much time,” or “you’re going to die” and then simply walk off down the hallway.

The reality of the situation, though still organically dramatic, tends to be much more helpful in terms of what comes next—especially when it comes to the language used to talk about death—if “death” is discussed much at all. 

“Isn’t ‘hospice’ just a word used to sugarcoat the concept of death?”

So, how do doctors tell patients they’re going to die? Well, in the way they convey most other information—with a plan. 

It’s very rare that the TV or movie scenario mentioned above is actually what one experiences in such a situation. When all efforts to preserve the length of a patient’s life begin to fail, the care strategy simply shifts to preserving the quality of a patient’s life. Around this time, a doctor will typically ask the patient or their immediate caretaker: 

“Have you all considered hospice care?” 

They may also simply state. 

“I think it would be a good idea for you to consider hospice care.” 

While this may seem like code-speak for telling someone they’re going to die from their condition and that doctors have given up on the patient, this isn’t necessarily the case. When the subject of hospice care is brought up by medical professionals, this is simply discussing an adjustment of their strategy. So, no, “hospice” and “death” are not synonymous—people have even “graduated” from hospice care before. 

And though “hospice” should not be synonymous with “death,” the terms closely coincide in the medical world. Why? Because medical professionals are plan-oriented care providers. Delivering a recommendation that you or a family member consider hospice care is not meant to make you ruminate on your mortality or become anxious, but rather to recommend the option that will result in the highest quality of life possible—as they would for any patient.

“So, is the word ‘hospice’ used to cushion the blow?”

It would be dishonest to state that some medical professionals don’t use the term “hospice” to cushion the blow of delivering an unfavorable prognosis. This has caused “hospice” to become a slightly loaded word. However, what comes to mind for patients or family members is not death, but rather continued care, comfort, and an end to many agonizing symptoms. For some patients who have experienced long, painful conditions and their associated painful treatments, hospice can be seen as a great relief.

Hospice Professionals in Tulsa, Oklahoma

If you or a loved one will need or is in need of professional hospice care, look no further than Cura HPC Hospice & Palliative Care. Reach out to speak to one of our experienced care specialists today.

“How do doctors break the news to a patient or their families that the patient is dying without seeming like they’re simply giving up hope?” 

Though everyone is going to die, most of us have not considered what that will look like or when it will be. This is the case even for many patients receiving care for serious conditions.

In most instances, for patients or their families, the realistic possibility of dying of a particular injury or disease is not a conversation they’re eager to initiate with a medical professional. This means that most medical professionals are forced to bring up the subject as carefully as possible. Broaching the subject without seeming like one is throwing in the towel is one of the most difficult conversations a doctor can initiate. It can be a balancing act in which not only is a dialogue about death is brought up, but from figuring out how to do so from a place of practical planning and care. 

Unfortunately, because most medical professionals are highly specialized in their field and not end of life care specifically, this means often means they need to call in the help of a hospice or palliative care professional. In the meantime, bringing up preparations for death with a patient or their families occurs in a few different ways using careful language.

When Dying Needs to Be Discussed Quickly

A conversation about dying usually comes about following or during a major health episode. These episodes can range from someone being admitted to a hospital with severe symptoms, their condition has suddenly deteriorated, or their condition has not improved and efforts to treat their disease have not had positive results. In these quicker instances, discussing the likelihood of not surviving can come as more of a shock to patients or their families because dying sooner rather than later simply wasn’t part of their plan. 

When death may be more imminent than originally thought, doctors must move fast if any care is to be administered that, though may not extend their life, will improve the quality of however much time they have left. Failure to initiate a conversation about death and the possibility of receiving hospice care or other palliative efforts can result in continued treatment that will only worsen the quality of the patient’s last days. When this is the case, discussing hospice care as soon as possible helps to preserve the patient’s quality of life for as long as possible.

When Dying is Brought Up Long Before It Occurs

There are other medical situations in which broaching the subject of the possibility of hospice care months or even years in advance is helpful for a patient with a terminal condition. While this initially seems like a gloomy forecast of their condition, it can actually be very helpful and reassuring for patients and their families to know that, no matter what happens, there is always a plan to preserve their patient’s quality of life as long as possible. 

Though it can seem scary or a sign of defeat for a medical professional to bring up the possibility of dying or hospice care, families should understand that doing so is simply a medical professional’s way of making sure their patient receives the absolute best care available—no matter what. 

Professional Hospice Care in Tulsa, Oklahoma

Speaking of receiving the absolute best care, if you or a loved one will need or are in need of professional hospice care, look no further than Cura HPC Hospice & Palliative Care.

We get it—it’s awkward for everyone. 

Whether you’re the caretaker of an elderly parent, an ill loved one, or an individual with dementia, bath time is likely one of the most challenging rituals of your care. But it doesn’t have to be. The following are a few tips to help make bathing less of an uphill battle and maybe even a treat. 

Tip 1. Check in with yourself before getting started. 

Even if the individual you’re helping bathe is visually-impaired or has advanced dementia, they will still be receptive to your attitude or demeanor going into any caretaking experience. If your facial expression, tone of voice, or body language is expressing uncertainty, squeamishness, nervousness, or annoyance, they will very likely mirror these feelings. 

Instead:

Approach bath time with optimism, confidence, and a calming influence. You may be quite surprised how receptive the individual becomes to what was ordinarily a time fraught with tension and discomfort. 

Tip 2. Prep the bathing space before getting started. 

Why would anyone want to take a shower or bath in a cold, wet, echo-filled place with potentially weird smells—also just to have you leaving to get more supplies periodically? 

Instead: 

1. Older and disabled individuals with circulation problems are more sensitive to the cold, so you will want to warm up the bathroom before bathtime. 
2. Consider lighting pleasantly scented candles or using nice-smelling soaps to make the space more inviting. 
3. Have all of your supplies within reach before starting bathtime. Having to leave the bathroom to fetch anything will make the person feel alone and may cause them to attempt to leave the bathroom—which is not only a mess waiting to happen but is also potentially dangerous. 

Tip 3. Strive to make the process less awkward and more private. 

Put yourself in their bath chair—having to be assisted with bathing is awkward. But you can make it seem less weird. 

Instead: 

Instead of just taking over the entire process and treating them like another chore, give them both privacy as well as a role. 

You can give them privacy by covering sensitive areas with washcloths. You can also give them washcloths to use to clean themselves while you’re cleaning other hard-to-reach areas. If they’re more responsible and less likely to make a mess, you could even give them the handheld showerhead to rinse themselves. 

Even if you have to go back over certain areas they didn’t quite clean, not only will this role make them feel more independent, but it will distract them from any perceived awkwardness related to being bathed. 

Tip 4. Luxuriate the experience. 

“C’mon—it’s bath time,” isn’t the most appealing sentence you could say to someone in need of a good washing.

Instead: 

When a loved one is in need of a bath, make the experience seem more luxurious for them. Don’t call it “bath time” or highlight the utility of the experience (“you stink and you need a bath”—possibly the worst thing you can say), instead call it “spa day” or offer them a nice “soak” or a “sauna experience.” 

Tip 5. Simplify the experience with the right tools.

Without the right tools, any job can become unpleasurable and stressful. Bathing is no exception. Even if you’re capable of hoisting this person into position and manually reaching all of the hard-to-reach areas, doing it the “hard way” can make the experience more intense and less enjoyable for them.

Instead: 

Invest in a handful of items that will make the washing experience not only easier for you but also more enjoyable for them. 

• A handheld showerhead is a must for washing a sitting individual—as well as letting them help out in the process.
• A shower chair and a larger shower opening can remove the challenge of getting in and out of a tub. 
• A transfer bench can help less-capable individuals enter the bathing space. 
• A variety of handles can help the person achieve stability in the bathroom—not only functionally useful but also helpful in increasing confidence.

Tip 6. End the experience with something they’ll look forward to. 

Even when bath time is over, many of those people cared for may still not have a positive association with the experience. And you may think you’ve done all you can. There are still ways to make their perception of bath time a more favorable one. 

Instead: 

At the end of every bath-time experience, provide the individual with a positive association—a treat or an expression of personal dignity. Perhaps a woman may enjoy an application of a favorite perfume. Maybe a fella appreciates a little aftershave or cologne. There may even be a favorite treat—such as tea, cocoa, or ice cream—that they enjoy and can begin to associate with the bath-time experience. 

Hospice & Palliative Care Services in Tulsa, Oklahoma

If you or a loved one is looking for professional and compassionate hospice and palliative care in the Greater Tulsa, Oklahoma area, look no further than your friends at Cura HPC Hospice & Palliative Care.

“I totally forgot to ask the doctor about…” 

Whether you’re going to the doctor for your own needs or as the caretaker for someone else, making the most of the appointment can be tricky. Why? Stressors related to conditions, a feeling like you’re wasting the doctor’s time, or even the feeling to need to make the most of this limited time with a medical professional can feel like you’re quickly throwing the entire appointment off target. 

The following are a few tips to lower the tension and make the most of doctor’s appointments for you or a loved one. 

Tip 1. Plan ahead before you plan ahead. 

A very simple way to make the most of appointments with doctors is to jot down all of the questions you wish to ask the doctor before you head out of the door for said appointment. For some, this works just fine. For others, attempting to rack their brain for all of the questions they want to ask just before an appointment is too much. 

What is the solution? 

Keep a running list a week in or more in advance. 

Whether you keep a journal or are familiar with a note-taking application on your phone, jot down your questions for you or your loved one’s doctor as soon as they arise. Then, the night before the appointment with the doctor, transfer these questions to a single sheet of paper or digital note to bring along to the appointment. 

Pro tip: If you’re jotting these questions down to bring with you, leave space on the paper to fill in the doctor’s reply. 

Tip 2. Get help guarding your attention. 

If you’re escorting a loved one to an appointment with their doctor, your first job is to be your loved one’s caretaker and secondly to be their advocate with the doctor. Unfortunately, being there for your loved one—especially a loved one with dementia—can overshadow your role as their patient advocate.

What is the solution? 

Get a friend to help. 

1. If you’re heading into a doctor’s appointment for a loved one where you have a lot of questions or you simply need to focus heavily on what the doctor is saying, recruit a friend or family member to assist in the caretaking duties.
2. If you don’t feel that additional caretaking abilities will be fully necessary, you can still opt to record the appointment using a voice recorder or specialized phone application. There is actually a medical appointment recorder and transcription application called Abridge that we have written about before. 

Tip 3. Set the agenda for the appointment from the outset. 

Doctors have a limited window of time to talk with their patients or advocates, so time is of the essence. It can be easy to feel slightly steamrolled by new information and forget that you have questions to ask. 

What is the solution? 

Let them know you have questions prepared before they even tell you any new updates. But then save them till the end.

As the doctor enters the room, after the initial greetings are dispensed, let them know that you have a number of questions for them. While they may then ask you to ask your questions, you may ask for the questions to be saved for after they dispense the information they have in case this new information answers any of the questions you have.

Once the doctor has finished with their news or questions for you, you can then ask your questions. Don’t feel odd about showing them your list of questions. It may also be helpful to include why you’re asking the questions you are—as the motivation for the questions can help doctors provide the most helpful answer. 

Tip 4. Repeat the doctor’s answer for confirmation or comprehension. 

Even when a doctor does answer your question, comprehending this answer for the average layman can be tricky. Even using a transcription app like Abridge can leave you later running to Google to make head-or-tails of what they said—and those answers can be terrifying when left to the internet to wrangle.

What is the solution? 

Repeat their answers in your own words back to them for confirmation. 

Once the doctor has given you an answer, repeating their answer back to them in your own words not only helps ensure that you understand what they are saying, but that they believe you understand what they said.

You may choose to reply by saying, “So, in other words…” before you repeat their answer in your own words. This will allow them to confirm or correct your understanding of the information. 

Tip 5. Write up your own summary of the appointment. 

So, you asked all of the questions you wanted to ask and received all kinds of new helpful information. Will this appointment seem just as helpful a week from now? Likely not. 

What is the solution? 

Jot down your own appointment summary. 

As soon as the doctor leaves the room, they will likely head back to their office to write up a summary of the appointment. You should do the same. As soon as you get back home and your loved one allows you the time to do so, handwrite a summary of the appointment. It doesn’t have to be word-for-word, but it should include the highlights of the appointment. Not only will this summary be helpful later for reference, but the act of writing it down will help you remember precisely what information was discussed. 

Hospice & Palliative Care Services in Tulsa, Oklahoma

If you or a loved one is looking for professional and compassionate hospice and palliative care in the Greater Tulsa, Oklahoma area, look no further than your friends at Cura HPC Hospice & Palliative Care.

“I didn’t realize it was an option!” - actual green burial proponent

For most people making their final arrangements, there seem to be only three options for their earthly remains: 

• Traditional Burial

This is the process by which a body is embalmed with chemicals, prepared for viewing, placed in a hardwood or metal casket, and buried within a concrete vault or liner in a landscaped cemetery with an ornately engraved headstone.

• Cremation

This is the process by which the body is placed in a cremation retort which is raised to over 1,400 degrees Fahrenheit. What is left of the body is ash and bone fragments, which are pulverized in a blender-like device called a “cremulator.” These cremated remains are then returned to the family. 

• Donation to Science

This is the process by which the body is given to a medical institution where it is dissected and examined by medical students before it is ultimately buried or cremated. 

For most, these options are suitable as they feel that there are few other options. 

For others, these options can seem unsettling, unnecessary, overly expensive, or unnatural. Fortunately for these individuals, a “new” third choice for body disposition is gaining popularity—green burial. 

What is Green Burial? 

Green burial—also known as “natural burial” or “eco burial”—is the process by which a body is laid to rest as naturally as possible. The bodies are typically not embalmed—usually only washed and dressed in very simple, biodegradable clothing. They are then placed in either a biodegradable casket (usually made of untreated wood or woven wicker) or even a sewn shroud, and placed directly in a shallow grave—often only three or four feet deep without any vault or grave liner. These graves are dug in special “green cemeteries”—areas left unlandscaped, containing wild grasses, trees, and wildlife. 

In many ways, green burial is seen as a return to the way most burials were conducted before the rise of the modern mortuary industry. Graveside funeral services often resemble that of earlier pioneers—allowing friends and family members to be as hands-on as they choose.

What is the Appeal of Green Burial? 

Environmentally Friendly

The earliest proponents of green burial were environmentalists looking for a more ecologically responsible way to return to the earth after death. 

Modern traditional burial not only requires the extensive clearing of natural lands to make way for heavily manicured cemeteries but also requires vast resources that are ultimately buried. Over an Olympic-sized swimming pool’s worth of toxic embalming fluid is buried every year as well enough metal (in the form of caskets) to build the Golden Gate Bridge, and cement (in the form of burial vaults) to build another highway between New York and Michigan. 

While cremation seems like the more environmentally friendly option, the process requires substantial energy and emits tons of carbon dioxide as well as other hazardous fumes such as mercury from dental work. 

Green burial, on the other hand, has been used as a method of wildlife preservation. The bodies of the buried feed the earth—nourishing plant life and soil conditions in the area. 

Respectful and Nondestructive

The practice of green burial appeals to many who find other options disrespectful of the remains of the deceased. 

Modern burial typically involves embalming a body—the process of replacing the blood with embalming fluid—sometimes using sharpened spear-like instruments to puncture the internal organs to remove excess fluid. 

Cremation is considered forbidden by observant Jewish and Islamic cultures, as it as seen as disrespectful of the body. 

Green burial seeks to respectfully return the body to the earth as naturally and directly as possible. 

Affordable

Short of direct cremation, green burial is among the most economic option for laying a body to rest. Modern sealed caskets can range from the thousands to tens of thousands of dollars—along with the cost of embalming, concrete burial vaults, cemetery maintenance fees, and elaborate grave markers—leaving the final price tag anywhere from $7,000 to $12,000 or even higher. 

Due to the lack of most of those elements, the cost of green burial can be a fraction of the cost. Plots in green cemeteries range from $1,000-$2,000. Burial shrouds can cost as little as $200. Funeral service costs may even be reduced as many family members and friends may elect to take on some of the responsibilities of a cemetery and funeral director themselves. Such tasks range from the care of the body to the digging of the shallow grave. Many funeral services have cropped up that aim to assist families in any duties they may not feel comfortable or capable performing. 

Is Green Burial Even Legal? 

Green burial is completely legal in all 50 states in the USA. Cemeteries may have regulations that require a burial vault and other items for burial on their sites, but such requirements are merely required cemetery policies and not law. The requirement for vaults or grave liners in modern cemeteries has more to do with preserving the landscaping than anything else.

What is the Downside of Green Burial? 

As it stands right now, the only apparent downside to green burial is the limited availability of green cemeteries and funeral directors with experience in assisting with green burial arrangements. Green cemeteries are typically areas of untouched land or adjoining sections of existing cemeteries that have been set aside for green burial. Still, as the popularity of green burial continues to grow, more funeral services and cemeteries have arisen to meet the growing demand.

How Can I Find a Green Burial Funeral Service or Green Cemetery?

To provide consumers with additional burial options and quality control measures, the Green Burial Council was formed. On their website, they provide a full listing of approved green burial funeral services and cemeteries.

Experience of a Green Funeral

“My wife’s great-grandmother and grandmother—mother and daughter—passed away in hospice care on the same day. They had lived together for over 30 years. They were lively, dignified ladies who lived vibrant lives, but wanted modest final sendoffs. Our family decided to honor them with a double green funeral and green burial. They were washed, clothed in simple gowns, and placed in white burial shrouds. We had a graveside funeral service in the forest with massive trees providing shade. We laid them side-by-side in a single, widened grave as family members and friends showered with them flower pedals. We passed shovels around with dozens of loved ones each delicately covering them with earth. More than feeling like we had them buried, we felt like we buried them ourselves—returning them to the earth, the bosom of their ancestors, and the embrace of their Creator.”

 - Green burial participant

Hospice & Palliative Care Services in Tulsa, Oklahoma

If you or a loved one is looking for professional and compassionate hospice and palliative care in the Greater Tulsa, Oklahoma area, look no further than your friends at Cura HPC Hospice & Palliative Care.

The decision to bring a loved one with dementia should not be rushed. 

As the holidays approach, we have the tendency to want to include all of our family for gatherings. Not wanting to exclude anyone, you may also want to include a loved one with dementia who is currently housed in a care facility—either for their dementia or possibly a hospice care facility. However, this can raise many questions—both logistical and emotional. 

• Will they be comfortable in such a setting? 
• Will the rest of the family members be comfortable with their presence? 
• Will this mean that I completely miss out on the gathering to meet their needs? 
• What happens when it’s time to return them to the facility and they refuse?
• Will they even remember the family gathering?

While these are good items to consider, it is also important to look for indications that this loved one may not be up for such a gathering. 

Red Flags for Attendance

Red Flag 1: If your loved one has a previous habit of voicing their displeasure with their facility. 

If your loved one with dementia has a habit of speaking extensively about how much they dislike their facility, these are not to be considered one-off comments. They are expressing a feeling they have that they may wish to express at a family gathering in the form of active resistance.

Red Flag 2: You already have trouble returning your loved one with dementia to their facility after visiting your home or other locations.

If your loved one has shown extreme hesitancy, frustration, or even resistance to returning to their care center after visiting your house or another location, that means that these feelings or behaviors may be intensified upon leaving a family gathering—even while still at the said family gathering. 

Red Flag 3: They have stated that they simply do not want to attend this family gathering or do not understand the concept. 

While you may feel that seeing some family members and getting out of the care facility may be in their best interest, fight the “you’ll thank me later” urge—thinking that they’ll come to enjoy the experience. They may, but they’ve also expressed that they do not wish to go and you should respect that wish by not pressuring them to attend. 

Logistics to Consider

If your loved one with dementia has not voiced displeasure with their care facility or resistance to returning to it, you may feel that it would be appropriate to take them to a family gathering for the holidays. While this is a valid decision that may end up being wonderful, it is important to plan ahead in case their mood sours—especially when it is time for them to return to the care facility. 

How will you make leaving enticing? 

Let’s say that your father has dementia, has expressed no ill feelings toward his care facility, and you wish to take him along to a family gathering. That’s wonderful! However, when it comes time to return and you say, “Ok, dad—it’s time to go back home,” he refuses. What should you do now? 

This is when it is important to make the prospect of leaving the family gathering enticing with something he likes. 

Perhaps instead of saying it is time to go home: 

• Have a family member say they want to show your father their new car
• Tell him that you wanted to take him to pick up some ice cream
• Tell him that you want to show him the pretty changing leaves
• Tell him that you’re all loading up in the car to see the neighborhood holiday lights

The important thing is to find something that will appeal to your loved one—something enticing enough to get him to willingly leave the situation. While it is important to not lie to him, simply create the journey home into a series of agreeable steps until he has reached his destination instead of one abrupt trip back to a place he may not want to go. 

Realizing the Why of Their AttendanceThough it may almost seem harsh to consider out of context, but before you decide that your loved one should attend this holiday family gathering, you will need a firm and simple reasoning why. This reason or lack of reason is not meant to more easily disqualify their attendance, but rather to ensure that this reason is being fulfilled. 

Not often enough good reasons: 

• “Well, it’s the holidays.”
• “Well, they’re family members.” 
• “I’d feel terrible if I didn’t bring them.”

All of these reasons are forgetting the most important contributing factor to this decision: your loved one. Instead of considering the benefits to them, such reasons are usually your reason why they should attend. In many instances, such events outside of the typical routine of someone with dementia can leave them confused and frustrated—not just immediately following the event, but also days or even weeks later.

However, if you feel that this experience may actually benefit their overall state, a family event may very well be a great idea. 

But how can you know? 

How to Consider if a Family Gathering is Good For Them 

When trying to determine if a holiday family gathering will be a good experience for them, it is important to consider the past, present, and future of their state. 

• How have they responded to going out and needing to return to their care center in the past?
• Will you be able to provide adequate care for them for the entire duration of the experience?
• Will this family gathering be positive for them or will it likely only cause confusion? 
• How likely are they to be receptive to returning? 
• How do you plan to entice them back to the care facility if they become confused, hesitant, or resistant? 
• How is this family gathering as well as their return to care expected to leave them feeling in the days following it? Happy? Confused? Agitated?
• Why do you think they should attend—for you, your family, or for their own wellbeing? 

There are several different aspects to consider when making the decision to bring a family member with dementia to a family gathering this season. Hopefully, this piece gives you a few more items and scenarios to consider for the health and happiness of your loved one. 

—------

Hospice & Palliative Care Services in Tulsa, Oklahoma

If you or a loved one is looking for professional and compassionate hospice and palliative care in the Greater Tulsa, Oklahoma area, look no further than your friends at Cura HPC Hospice & Palliative Care.

In our last article entitled How to Manage Frustration Among Loved Ones With Dementia, we discussed how to respond to a moment of anger or fear experienced by a loved one realizing that they are experiencing symptoms of their dementia. In this piece, we’re going to look at how simple, tactful actions on your part can help limit the frequency of negative experiences. 

Prevention Requires Understanding

Before you can aim to prevent moments of frustration experienced by a loved one with dementia, you must understand which experiences may trigger frustration. For example, noticing a frustration with activities that require dexterity, such as tying shoes or cutting up food, should warrant your consideration for an environmental shift. A lagging memory may also motivate you to tactfully limit such episodes of mental stress. 

Discretion in Prevention

Though you should absolutely respond to an experience that triggers genuine frustration, not all difficult situations may trigger frustration. In fact, if you swoop in prematurely to remedy a situation that has not yet triggered frustration, though you feel you are preventing frustration, you may actually be inciting it. 

An example of this may be speaking for a loved one at the first sign of mental lapse or even not giving them the opportunity to answer a question at all. Though not recalling the details of a story or someone’s name can be frustrating, give them a few moments to attempt to recall such details before lending your assistance. Speaking for them before they appear to be frustrated may make them feel as though you doubt their abilities, which may be construed as disrespect.

Tact = Dignity

When aiming to prevent moments of frustration experienced by a loved one with dementia, it is essential to be both tactful and subtle to respect their dignity. Calling attention to their inabilities or treating them differently from others in an overt fashion may even cause them to feel embarrassed. 

Not Calling Attention to Their Disability Among Others

One example of discreetly preventing frustration may exist at the dinner table. Though you may feel you are being helpful and preventing frustration by cutting up their food, doing so for them and no one else may cause them to feel embarrassed. Instead, if you’ve observed that cutting such food will likely be frustrating for them, consider cutting up all of the food for all guests into edible, fork-ready sizes in the preparation process without explaining why. 

Tactful Changes in Environment

Another example displaying such tact may include self-care in the form of shoes. If you notice that a loved one is struggling to tie their shoes, an obvious remedy would be buying them velcro or slip-on shoes. The key aspect of this action is discretion. Do not say you did so because you noticed that they struggle to tie their shoes. Instead, frame the new shoes as a gift, maybe that you thought the color would complement their handbag or some other kind-yet-benign reason. 

Gauge How Your Prevention Techniques Are Received

Whether you’re responding to moments of frustration or aiming to tactfully prevent frustrating experiences, it is important to carefully gauge how your assistance is received. One of the best responses is little response at all—not detecting the subtle changes to their environment while enjoying their benefit. If you feel that your preventative measures are being negatively received by your loved one with dementia, you may consider scaling some of your measures back or strategize how to make them less overt. 

Caring for your loved one with dementia is frequently a balancing act in providing appropriate care while respecting their dignity. Doing so effectively will allow you to meet their needs while preventing frustrating experiences.

Hospice & Palliative Care Services in Tulsa and Oklahoma City, Oklahoma

If you or a loved one is looking for professional and compassionate hospice and palliative care in the Greater Tulsa, Oklahoma area, look no further than your friends at Cura HPC Hospice & Palliative Care.

Early-stage dementia can be frustrating and scary for anyone. 

Unlike patients in which round-the-clock assistance is typically required and disability may not be fully realized by the patient, those with mild dementia have the unfortunate experience of witnessing their own symptoms in a more intimate way. This new realization that they may not be able to process thoughts or perform certain activities that they once could may be especially troubling. However, there are several ways that you can soften the emotional burden they experience. 

In this piece, we’re going to look at how to best respond to frustrating moments experienced by loved ones with early-stage dementia.

Responding to Dementia-Induced Frustration

Frustration and fear are common emotions among those actively experiencing the symptoms of dementia. The inability to recall a detail or perform an ordinary task may be deeply troubling. How you, a loved one, respond to this frustration can have a profound impact on their overall happiness. Here are a few ideas on how to most appropriately respond. 

Provide Comfort

Experiencing the initial stages of dementia can feel isolating. When you notice they are troubled by the realization of their new limitations, give them comfort and support. Tell them that it’s ok, that you’re there for them, and that you are a team. 

Normalize or Rationalize Limitations

Some mental or physical tasks may be frustrating for those with dementia that aren’t especially easy for everyone. When a loved one struggles, provide a bit of empathy. Even a casual, “Man, the kids are growing up so fast—I can hardly put names with their faces either!” or “I could barely open that jar myself!” 

Lighten Frustrations with a Joke

This technique requires a deep understanding of a loved one’s personality, but sometimes a little humor can greatly soften a frustrating situation. Tying into normalizing or rationalizing their symptoms, consider peppering it with a little joke. 

Playing Down by Playing Off

Consider playing down brief forgetfulness by playing off of an event of forgetfulness they experienced as an able-minded person or a silly excuse for one’s inability to perform a particular task.

• “You always did confuse me with my sister, didn’t you? Sometimes my kids call their aunt ‘mom’ as well!”
• “I think you’re just trying to get out of doing some chores, silly lady!” 

Comfort With Your Honesty

At times, your loved one with dementia won’t want to hear jokes, they won’t buy your rationalizations, and they won’t want to be coddled by your comfort. For these types of loved ones with whom you have a close bond, hearing the truth from you can help ease their frustration. When they can see through the candy-coating, they may respect your ability to discuss the gorilla in the room—that this is hard and they need help. 

In these moments, being truly honest may be the best therapy. Your ability to be honest with them will show how deeply you respect them. This respect will very likely be reciprocated and the trust that follows that respect can provide comfort. 

In our next article entitled How to Help Prevent Frustration Among Loved Ones With Dementia, we’ll discuss how to hopefully prevent frustration among your loved ones experiencing the symptoms of progressing dementia. 

Hospice & Palliative Care Services in Tulsa and Oklahoma City, Oklahoma

If you or a loved one is looking for professional and compassionate hospice and palliative care in the Greater Tulsa and Oklahoma City, Oklahoma area, look no further than your friends at Cura HPC Hospice & Palliative Care.

If you’re a caretaker of a loved one with dementia, you know that their confusion typically results in many different questions. The more disoriented they may become, the more questions they may ask. They may ask about a job they haven’t worked in years. They might ask about a home that they were forced to move out of due to their condition. They may even ask about a spouse or other loved one who has been deceased for decades. 

Reasoning with Dementia Patients Rarely Works

As logical people, we’re conditioned to want to answer questions truthfully. When it comes to caring for loved ones with dementia, you’ll quickly realize that they’re rarely thinking logically when it pertains to the specifics of their immediate surroundings. They may ask where their cat is—though they themselves had to take the cat to be put to sleep 20 years ago. If you were to answer them logically and thus truthfully, you would likely upset them very much. The next day, they may ask about the cat once again—and thus force you to repeat the painful and confusing truth all over again. 

Compassionate Responses Rather Than Truthful Answers

So, how do you respond to tricky questions when the truth would only upset your loved ones with dementia? By responding with a compassionate response rather than a truthful one. It is also helpful to pivot the subject to a new activity to take their mind off such questions.   

The following are a few examples: 

Your mother asks about her cat Mittens who has been gone a long time.

• Truthful answer: “Mittens had to be put down over 20 years ago, Mom.”
• Compassionate response: “Mitten is sleeping. Let’s go for a walk.”

Your father wants to go home, though he’s had to move in with you due to his condition. 

• Truthful answer: Dad, you live with me now. We sold your house to the McKinneys. 
• Compassionate response: That’s very far away. I made up a room for you at my house and I’m making dinner for us tonight. 

Your husband wakes up in a panic because he thinks he’s late for work, even though he’s been retired for 15 years. 

• Truthful answer: You haven’t worked at that job for 15 years. You’re retired. 
• Compassionate response: You’re off work today. Would you like to help me with this puzzle? 

For most tricky questions for which a truthful answer would only result in upsetting your loved one with dementia, there are likely an array of compassionate responses you can employ. It’s likely worthwhile for you to have a few such responses at the ready so that you can avoid confusing or upsetting experiences. It’s also helpful to keep your compassionate responses consistent in case they recall what you've said in the past.

Hospice & Palliative Care Services in Tulsa, Oklahoma

If you or a loved one is looking for professional and compassionate hospice and palliative care in the Greater Tulsa, Oklahoma area, look no further than your friends at Cura HPC Hospice & Palliative Care.

Are you experiencing caretaker’s guilt or burnout?

As the caretaker of a loved one in need—whether this is a spouse with dementia or a parent with a serious condition, you likely feel as though the weight of their entire world is on your shoulders. While there is some truth to the weight of this, you may be feeling a secondary weight—a self-imposed weight of unnecessary guilt over experiencing pleasure for yourself during this time.

This may be a state unofficially known as caretaker guilt. This type of guilt is normal, but when left unchecked, can result in caretaker burnout. Identifying unnecessary guilt is very important.

Have you found yourself...

• Turning down friendly invitations to enjoyable events you realistically could attend with the right logistics?
• Taking up friends or family on these invitations but not being present during these moments because you’re too wrapped up in guilt over your loved one not being able to have similar getaways?
• Ruminating about all the various factors that could go wrong in the care of your loved one rather than what actually is occurring on a daily basis?
• Not giving yourself breaks or restorative getaways from caretaking because you feel guilty about your loved one not receiving such breaks or getaways from their condition?

If this sounds like you, take a minute to consider the following: 

In the grand scheme of your loved one’s care, is your refusal to enjoy pleasurable experiences helping or hurting your ability to provide quality care? 

If you’re truly honest with yourself, you’re able to see that being engrossed in guilt, rumination, and round-the-clock focus is more of a recipe for burnout than a lapse in care. In fact, if anything, caretaker burnout should be a greater concern than any imagined unfortunate event. 

How to Alleviate Caretaker Guilt & Burnout

Turn Off Your Automatic “No, I Can’t” Mindset

As the caretaker of someone with a serious condition, you’ve likely turned your personal “We’re Open” sign to permanently “Sorry, We’re Closed” when it comes to invites to outings you would enjoy. While it’s true that you likely have to turn down the majority of invitations, “no” shouldn’t be your default reply.

• Take a moment to consider if you’re reflexively saying “no” or if you could actually make it work. 
• Weigh the cost-benefit analysis of arranging a few hours of relief from a nearby sibling or close friend. (Spoiler alert: it’s worth it.)
• Don’t assume that you’re burdening others by requesting relief. You may even be surprised by how many people care about you and would love to help.  

Arrange a Regular Getaway

By now (and likely even before reading this article), you probably understand that your existing or impending burnout is not helping anyone—not your loved one, not your family, and especially not you. And you’re probably already coming up with excuses for not taking a break:

• I don’t want to deal with the hassle of finding someone to relieve me. 
• I feel selfish asking someone else to give me a break. 
• I don’t want to subject my loved one to the idea of me randomly leaving to get a break.

It may be true that getting someone to tend to the needs of this loved one at a moment’s notice would be hard on everyone involved. However, with a little planning and explanation, you can generate the initial momentum necessary for you to have a regularly occurring time to recharge. 

• Step 1: Realize that you need periodic breaks or getaways from your role as caretaker—not because you’re lazy or callous but because you’re human. You likely already realize the need for these breaks or getaways. 
• Step 2: Reach out to your close friends and loved ones—preferably individuals familiar with your situation—to inquire about who might be able to relieve you for a few hours a week so you can recharge. This may be as simple as sending a group text message to a handful of close friends and family members or even asking a close friend to call around for you. You may be pleasantly surprised by how many people offer their help! 
• Step 3: Plan your regular getaways. It’s best to choose the same times and days of the week so that it doesn’t take anyone by surprise. These getaways don’t have to be anything extravagant—even just coffee at a friend’s house, a trip to the library, to catch a movie, or a bite to eat at a local café. It’s best if these getaways are truly away from the house or care center—otherwise, you’ll never fully allow yourself to separate your mind and recharge. 

Help is Closer Than You Think

It's one thing to recognize that caretaker burnout is detrimental to everyone involved—doing something about it is something else. As we’ve mentioned before, you’re not selfish for wanting to periodically treat yourself. Taking the appropriate time to care for yourself will make you a better caretaker for your loved one. 

Hospice & Palliative Care Services in Tulsa, Oklahoma

If you or a loved one are looking for professional and compassionate hospice and palliative care in the Greater Tulsa, Oklahoma area, look no further than your friends at Cura HPC Hospice & Palliative Care.

They’re not just trying to annoy you. 

If you have a loved one with dementia, you’re likely very accustomed to being asked the same question several times a day. Though you do your best to answer it every time, their condition means they not only don’t remember your answer but likely don’t remember asking. Though this repetition can be frustrating, the following are four helpful ways to address a loved one with dementia asking the same questions over and over. 

1. Firstly, the most obvious approach — just answer it. 

You may find yourself frustrated with hearing and answering the same question over and over. When this takes place with a loved one with dementia, one of the easiest ways to handle seemingly harmless questions are is to simply answer them as though you also do not remember hearing such questions before. Remember — it is the condition that is causing them to forget your answers. Answering the same questions several times a day is likely the new normal. Coming to terms with this may save you a lot of grief. 

2.  A distraction to a suitable activity may be helpful. 

Some questions can be quickly and easily answered. Other questions may result in complicated or disappointing answers that will be quickly forgotten — though the negative emotions from such answers may remain. To limit having to answer such questions, distracting your loved one from the question with a positive activity may be helpful. Some caregivers suggest a fun or safe activity such as a game or simple craft project. Others have reported that using a bit of humor can distract your loved one from their intention for asking such questions. Still, more caregivers have suggested asking the loved one if they would like to listen to some of their favorite music. These activities have the advantage of not only deflecting repetitious or anxious questions but also take the patient’s mind off any anxieties that inspired such questions — such as why they can’t drive their car or go out by themselves. 

3. Direct their attention to a visual cue that answers their question. 

Just because someone with dementia asks the same question does not mean that it cannot be answered in a meaningful way. One way to answer a question is by diverting its answer to a visual cue. If a loved one with dementia keeps asking about the date or the day’s activities, consider hanging an easily visible calendar on the wall that lists their scheduled activities. Not only will a calendar answer their questions in a satisfying way, but they may also grow conditioned to consult the calendar for such questions instead of repeatedly asking you.

4. Identify and remove what is triggering the question. 

Very few dementia patients will suddenly shift behavior without a sufficient cue. The difficulty on behalf of caregivers is identifying which cues will trigger which behaviors — including the asking of repetitious questions. For instance, you may notice a loved one asking about a certain family member every time they go to the bathroom. Walking the same path, you may discover that they walk past a photo of this family member on their way back from using the bathroom. By moving the photograph or other cue to a location in the home with less regular traffic, you may reduce the repetition of such questions. 

Remember — if you are frustrated, they are confused. 

Despite which of these techniques you attempt to remedy the repetitious questions, remember that your loved one with dementia wouldn’t be asking if they weren’t genuinely confused. Keeping this in mind can greatly decrease any frustration you feel after being asked the same question for the third, fourth, or even twentieth time in a row. 

Palliative care and hospice services in the Greater Tulsa area.

When the time comes for requiring nurturing hospice and palliative care for your loved one, know that you and your family can trust the professional from Cura HPC. We treat every patient as we’d treat our own family — with compassion and the utmost care. 

Learn more about Cura HPC today.

Even when the problem is imagined, the hurt is real.

When caring for a loved one with dementia, there are several irrational behaviors that require a specialized response. Your response may require identifying imagined triggers and calming down your loved one. However, there are other instances when, though the negative behavior is rooted in their mental condition, the hurt is real. 

Some examples: 

• A loved one becomes frustrated about losing the ability to perform an activity that they recall being able to do without help. 
• A loved one somehow believes something about someone that isn’t true and cannot be convinced otherwise. 

Though rooted in a dementia-related cause, the corresponding negative emotions are quite real — unable to be explained away or soothed. So, what next? 

The pain is real — so treat it as such.

It can be easy for the caretaker of someone with dementia to forget that sometimes people experience hurt not because they have dementia, but because they’re human. Whether they feel they’ve been belittled or they’re just upset because they can no longer operate a coffee maker, the hurt is genuine. The best response in these situations is the same support you’d provide for any frustrated friend or loved one. 

Be there to listen. 

Just like any friend who needs to vent about a problem they’re having at work or in a relationship, your loved one with dementia is no different. Genuinely listen to what is troubling them. More often than not, the sensation of being heard will help them feel better. 

Support them. 

Many negative emotions simply need a listening ear. Others require a shoulder. When you can offer comforting support, do so not from the perspective of a caregiver but as a loved one or friend. When you feel it is appropriate, share a similar experience you’ve had and how you dealt with it. Offer to help in any way you can. 

When in doubt, put yourself in their shoes. 

Helping someone with dementia navigate negative emotions can be incredibly tricky. You’ll feel the need to consult every blog or book under the sun on the issue. Where should you start? Well, a good place to look is in their shoes. Look through their eyes and their thought process. The hurt you would be feeling is real and being told that it is imagined isn’t what you’d want to hear. Sometimes, a little role reversal can make all the difference in providing the most customized and loving care possible. 

Not everything is dementia’s fault. 

It can be easy to forget that, though a loved one is experienced advanced dementia, that their condition may not be the sole reason for their frustration or hurt. For this reason, it’s essential to treat the loved one as a person with genuine hurt and not just a person with a mental condition. 

Palliative care and hospice services in the Greater Tulsa area.

When the time comes for requiring nurturing hospice and palliative care for your loved one, know that you and your family can trust the professional from Cura HPC. We treat every patient as we’d treat our own family — with compassion and the utmost care. 

Learn more about Cura HPC today.

The need for help doesn't mean you’ve given up. 

There is a belief among some that nursing homes exist to care for those without family or whose family does not want to do the necessary work in carrying for them. Before we proceed in this piece, we must strongly dispel this myth that does immense harm to both patients and their loved ones alike. 

No two dementia patients are alike.

Despite the type of dementia or the stage, no conditional level determines the style of care required. Optimal care should be determined on a case-by-case basis and involves a wide variety of factors. This can mean that one extremely advanced Alzheimer’s patient may never need nursing home care while someone else at a less advanced stage may require around-the-clock professional care just depending on the following factors. 

Do you worry about their safety?

If your loved one is a threat to their own safety, nursing home care may be warranted. 

Do they wander off? 

If your loved one is a wanderer, there's a strong chance that belong in a facility that will limit this behavior before it becomes dangerous for them. You probably cannot provide the amount of surveillance and restraint necessary to care for a loved one who is prone to wandering off — especially if you live in a place with extreme climates at different times during the year. 

Can they detect and appropriately respond to danger? 

As a loved one’s dementia progresses, they may begin to lose the instinctual ability to detect, respond to, or avoid danger. When faced with an emergency, they may lack the wherewithal to alert the authorities, to ask for help, or to preserve their own safety, or to guard sensitive information from strangers. 

Do you worry about their bodily functions? 

While it is normal to have to clean up a mess here and there for most patients, once a patient has lost most control of their bodily functions, they likely require more help than one loved one can provide. 

A loss of bowel control can quickly progress from frustrating to exhausting to dangerous. For patients who have frequent accidents or have lost control of their bodily functions altogether, the level of necessary care can exceed the abilities of a well-intended loved one. These patients may become uncooperative during necessary changes or even resist the necessary process of cleaning them. Such living conditions may exceed the abilities of an at-home caregiver and require additional help. 

Do you worry about your own wellbeing? 

While there certain people out there who would just as soon turn family members over to professionals at the slightest inconvenience, there are others who would sooner thoroughly exhaust themselves, risking their own health, to avoid using nursing homes. Neither of these situations is ideal. 

The right decision includes your well-being, too. 

It is normal for someone to feel guilty about checking a loved one into a nursing home. However, when the duties of caring for a loved one threaten your own health (physical, mental, etc.), family life, or even steady income, a nursing home should always be a guilt-free option. 

Once you’ve allowed yourself to be honest with your thoughts, you may come to realize that the ideal care for your loved one includes preserving your own mental and physical well-being as well. 

Don’t think of it as outsourcing care, but rather supplementing care with help from professionals. This professional help will allow you to be the most beneficial version of yourself for your loved one.

Compassionate Hospice & Palliative Care in Tulsa, OK

For families in need of professional and compassionate hospice and palliative care in the Greater Tulsa, Oklahoma area, Cura HPC Hospice & Palliative Care can help.

Learn more about and connect with Cura HPC today. 

“How do I know if I’m doing a good job?” 

As the caregiver of someone with dementia, it can be tough to know if you’re doing an excellent job or if you’re out of your depth. It is critical to use the correct “performance indicators” when trying to gauge the quality of the care you’re providing.

Firstly — Yes, You Are

Indeed, we’ve never met. We have not sat in on a day with you and your loved one. However, simply because you care enough to research how to be a better caregiver automatically means your heart is in the right place. So, before we jump into assessing performance, know that you’re off to a great start. 

Why Patient Happiness is Not a Great Performance Indicator

It’s easy to feel like a lousy dementia patient caregiver following an uncomfortable situation. However, simply asking, “are they happy right now?” is a very poor indicator of the quality of care you’re providing. Why? Well, let’s look at the unique circumstances impacting a dementia patient: 

• As their condition declines, they’re likely losing abilities.
• As they lose abilities, this usually means losing “privileges” — such as operating a car, leaving the house alone, cooking, or handling their finances.
• All of these lost abilities and privileges are bound to make them confused and upset.

While you could give in and give them immediate happiness by granting their request to take their car for a spin or take control of their credit card information, this is not an indication of quality care. The same could be said about a parent who simply gives into their children’s demands when the results are unfavorable or even dangerous. 

Patient happiness is also not a good gauge of the quality of your care because it leaves out a crucial element — your wellbeing. It is not uncommon for a caregiver to put the happiness of their loved one above their own health and happiness. Not only can this complete selflessness result in a lower quality of care in the long run as you’re completely worn out, but it may even result in you sacrificing your own health. You must tend to your own emotional and physical needs to continue delivering quality care. 

But what are good performance indicators for dementia caregivers?

You probably wish there was a simple checklist to fulfill to determine if you’re doing a good job. So, what is a good performance indicator for dementia caregivers? Simply put, how well you manage the difficult decisions. 

There will be a lot of no-win situations. 

You want to make your loved one with dementia as happy and comfortable as possible. However, you’ll be frequently required to say “no,” — which may upset the patient. Most of these occasions will not only be for their own good but also your own long-term preservation as a caregiver. These scenarios may have no outcome that keeps the patient simultaneously happy and safe. 

Understand that saying “no” is not a failure on your part, and a safe yet upset loved one does not make you a bad caregiver. It makes you a compassionate person who — yes — is doing a great job. 

Compassionate Hospice & Palliative Care in Tulsa, OK

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Most people these days would prefer not to talk about death. The subject matter itself makes them uncomfortable, let alone the emotions about such finality or unease it conjures. Still, for most, this conversation is immensely beneficial — not only for the dying individual but also those they leave behind. With this, there are several ways to minimize the awkwardness and uneasiness associated with such subject matter and infuse the interaction with support. 

1. Sit on the same level as the person.

Our stature during a conversation can communicate almost as much as the content of our speech. When speaking to a dying person, especially when delivering difficult information, try to bring your face level with their face as much as possible. This signifies that you are there with them in a supportive capacity. 

2. Put aside any objects between you and the person. 

Whether we realize it or not, we often use objects in a room to shield ourselves from discomfort. A phone may feel like an escape hatch from a socially awkward encounter. A book may be a quick change of subject or focus when the topic becomes displeasing. When speaking to someone about death — their impending death or your own — strive to remove any barriers. Even sitting across the table from a person can make them feel that much more distant from you or that your differing fates are emotionally separated by the piece of furniture. And, of course, silence all phones and put them entirely out of sight. 

3. Speak to the person straight forward in an open body posture. 

Those speaking about dying want to feel heard as much as possible. Crossing your arms or legs or sitting sideways (such as in a car) does not tell them you are ready to listen to what they have to say carefully. When you speak about death or dying, make sure to be presenting an open body posture that says, “I’m listening.” 

• Align your shoulders with their shoulders — striving to keep your collar bones parallel with theirs’. 
• Keep your legs uncrossed. 
• Keep your hands and arms resting comfortably on your knees or thighs — not crossed over your body. 
• Keep your hands fully visible — out of pockets, behind your back, or away from the sides of the seat of your chair.
• Do not recline or lean sideways against an object in a casual manner. Instead, lean slightly forward in their direction.
• Keep your feet aligned with theirs.
• Gesture with open palms to signify your support.

4. Signify that you’re listening with responsive behavior. 

Even after removing all previously-mentioned obstacles to the conversation, it’s still possible for the person to not feel they have your full attention if you’re not responding appropriately.

• Keep natural eye contact with the person while speaking and listening.
• Gesture that you’re listening with appropriate nods or responsive — not reactive — facial expressions. Remain mindful of what your face is saying and how it may differ from your words or notions. 
• Consider if bodily contact may be appropriate — such as holding their hand while speaking or occasionally touching their shoulder or knee for comfort or to express your dedication to their support. The decision to employ bodily contact will depend on the individual and your relationship. 
• Delivering a warm smile when discussing one’s support network can go a long way towards helping someone feel loved and taken care of, but remember to keep the appropriateness of certain facial expressions in mind. 

5. Conclude with as much warmth as possible (and is appropriate). 

Speaking to someone about death or dying can feel immensely disorienting. Such conversations can almost feel like the oxygen has been sucked out of the room. Do your best to provide loving assurance and your dedication to supporting them. Make sure to summarize the next steps in their care and give them a means of contacting you. Concluding with a hug or other bodily contact—a handhold, a gentle shoulder squeeze, a kiss on the cheek, etc.—any actions to soothe anxiety may be helpful.

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Being disqualified from anything can be lousy. Being disqualified from hospice, however, can result in many mixed emotions. But yes, it can happen. However, understanding the role of hospice can help clarify issues of no longer qualifying for hospice care. 

Hospice is Not About Giving Up

When many people hear “hospice care,” they immediately assume that someone and their doctors have given up hope. This misconception has led to many attempting to stray as far away from hospice as possible. Hospice is not simply preparing for death (something everyone should be doing regardless of their health condition) but is, instead, a style of care designed for those not expected to survive severe health conditions for the next six months. 

Sure, this care is not generally aimed at curative treatment, but that, by no means, should brand it as “giving up hope.” Where hospice differs from curative treatment is that it aims to increase the patient’s quality of life over recovery from the particular ailment — whose treatment can significantly decrease their quality of life, even when a cure is unlikely. 

Some People “Graduate” Hospice

Most people enter into hospice care when a doctor determines that they are unlikely to survive their condition for another six months. This time span was largely developed by health insurance companies and Medicare to determine coverage spans, though it is useful by the medical establishment as well. 

So, what happens if someone lives longer than six months while in hospice care? If this occurs, the patient is usually reevaluated to determine their continued eligibility for hospice care. Many may have their hospice care stay extended by as much as another six months. Others, however, may “graduate” hospice — being no longer eligible for hospice care either due to a health improvement or because the patient has chosen to discontinue hospice care — either to continue to seek curative treatment or be admitted to another style of care facility, such as a nursing home and the like. 

Conclusion

Is it possible to “graduate” hospice care? Yes. While this is the case, this is not the goal of hospice care and does not necessarily mean that the patient will recover or will even experience a better quality of life outside of hospice care. Many graduations are temporary and the patient may ultimately return to hospice care at a later time due to the same condition. Leaving hospice care — either through “graduation,” “live discharge,” or disqualification simply means that hospice care does not best fit the patient’s current condition or desires. 

Hospice & Palliative Care to the Greater Tulsa, OK Area

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For the very fortunate, end-of-life care can be managed by a loving family member. For many, their spouse may have already passed away or will not be up to the task due to age or state of their own health. In these instances, it’s common for another family member to step in and assist. However, what happens if no biological family members are available to make medical decisions for a hospice patient? Can a dear friend step in? The answer to this question can be very complicated. 

The Second Choice Scenario - Planning For a Lack of Next-of-Kin

We’d all like to believe that when the time comes to make important decisions about our end-of-life care, that our spouses or children will be there. Even if this isn’t the case, we like to believe that we’ll be able to select a good friend who can make decisions on our behalf. However, a deteriorating health condition that may result in the need for hospice care may outpace our ability to make such decisions if a next-of-kin is unavailable. For this reason, every person needs to establish a chain-of-command of decision-makers regarding their care. Such decisions can be made while setting an Advance Directive, Living Will, or even writing out one’s final wishes. This chain of command should extend far beyond one’s own biological family. All responsibilities should be confirmed with those involved to ensure they understand and consent to such duties. 

Why Making Health Wishes Legally Binding is Important

Though scribbling out one’s last wishes on a piece of paper, it is important that these wishes are backed with legal authority. Why? The Health Insurance Portability and Accountability Act (HIPAA), the primary legal act protecting patients’ medical privacy in the United States, protects the disclosure of private health information of patients against outside sources. This means that even family members may not be able to access a loved one’s medical information without the proper release documents. When time is of the essence and making decisions about another’s care can’t wait, it is advantageous for those intended decision-makers to have the necessary medical clearance. 

It’s crucial to have a legal professional or medical organization assist you in providing medical release forms for the intended decision-makers. Keep all release forms in a safe and convenient location along with other vital documents.

Conclusion

So, can a close friend manage someone’s medical care? If the proper planning is done ahead of time — absolutely. If, however, arrangements are delayed until the patient can no longer consent to said medical release, the chances being possible might be unlikely. This is why it is crucial to make arrangements in advance with a legal professional with knowledge of HIPAA requirements. 

Hospice & Palliative Care to the Greater Tulsa, OK Area

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Dementia is one of the most complicated conditions one can experience. Not only are there various types and degrees of dementia, but there are many conditions that appear as dementia, though they aren’t. For this reason, a clear diagnosis is crucial for treating these conditions and managing symptoms. In this piece, we’re going to look at the types of doctors most likely to diagnose dementia and how they come to their diagnostic conclusions. 

1. Your Loved One’s Primary Care Physician

A primary care physician is a gateway to additional care for most individuals — and those displaying symptoms of dementia are no exception. Though a primary care physician may not specialize in neurological conditions, they can still diagnose many conditions that may present themselves as dementia. For example, a primary care physician may be able to diagnose hearing and vision problems that can cause confusion that resembles dementia. PCPs may also be able to run blood tests to identify other conditions or spot adverse reactions to medications or even allergic reactions. While a PCP can do quite a bit, it is very rare that a dementia patient’s care will be limited to the care of a primary care physician.

When a primary care physician deems it necessary, they will likely refer your loved one to a neurologist.   

2. A Neurologist

The most common specialist responsible for diagnosing and prescribing care for dementia will be a neurologist. As specialists in the brain and cognitive function, a neurologist will delve much deeper than a primary care physician for a more accurate diagnosis. A neurologist may conduct physical examinations, run blood work, or conduct scans of the brain. These cognitive specialists may prescribe certain medications to treat conditions and the like. 

If a neurologist is unable to accurately diagnose a particular type or degree of dementia, they may refer the patient to the care of a neuropsychologist. 

3. A Neuropsychologist

Combining the expertise of a neurologist and a psychologist, a neuropsychologist specializes in diagnosing and treating psychological issues rooted in neurological disfunction. They often perform in-depth investigations into the type and degree of dementia by conducting interviews, asking patients to draw objects or symbols, repeat specific statements, and the like. Many of the tests utilized by neuropsychologists are not widely publicized in order to maintain the tests’ integrity and keep diagnoses accurate.  

The process of diagnosis can be immensely confusing for patients and stressful for loved ones, but with the right specialists, your loved one can receive the professional and compassionate care they deserve. 

Hospice & Palliative Care to the Greater Tulsa Area

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The following is a personal account of someone who is not an employee of Cura HPC. A few details have been changed or omitted to respect the privacy of those involved, but the rest is true.

The last time I had seen Don, he was beaming with more than happiness and strength—he seemed downright victorious. 

“Man, am I glad to see you!” I said as I gave him a bear hug around his now-scrawny frame. I didn’t mention that it was because Don had been battling cancer for months and had just been told that the brutal treatments had been successful. 

Though months of treatments had resulted in him now being half of his original size, he hadn’t been a skinny fella before the diagnosis, so he carried his new frame well. In the dimly-lit downtown lounge, he, my brother, Don’s military-pilot son, and I shared drinks and caught up after almost a year apart. Though we weren’t necessarily toasting to Don’s victory over his cancer, it definitely hung in the air like a delicious aroma. 

I still have a picture of the four of us together, taken by a kind stranger whom my brother had asked to snap a picture. A mere selfie wouldn’t do. 

Don isn’t a family member, but he might as well be. He’s my brother’s ex-father-in-law — which makes him my...friend? Despite this, my brother and I share an affinity for Don that we don’t have with many biological relatives. He’s larger than life, so to speak. He’s always been the life of the party and the someone you can call when you’re in a jam. Everyone he knows has a Don story — and he’s quick to tell you what actually happened...though his version isn’t any less hilarious or crazy — he would just tell it as though the events were no big deal. Classic Don. 

Months after that night at the downtown watering hole, the pandemic hit, and everything went into lockdown. I didn’t hear from Don because I hadn’t really heard from anyone. Before the pandemic, I had opted out of social media in lieu of personal interactions and was beginning to regret it a bit. One night, the topic of Don came up with my parents—the few people within my germ circle who were also on social media. 

“Man, I miss Don. How’s he doing?” I said with a smile. 

Both of my parents’ faces drooped and they looked at each other, so as to say, “oh, yeah...he doesn’t know.” 

“His cancer came back. That’s about all we know,” my mom said. 

The rest of my evening was fairly deflated and thoughts of Don swirled. 

A few weeks went by. While working in my home office, my brother called. 

“Don is in hospice.” 

My heart sank and my feet started to physically tingle with shock. After a bit of silence, my brother asked if I was still on the line. I was, I just had to take a bit of time to regroup. Don, whom I’d always seen as the pinnacle of strength, bulletproof, and always ready with a snarky comment, was now dying. This new reality left me shaken and disoriented. 

“I’m coming to town this weekend to see Don while I still can,” my brother said. 

Over the next few days, I wrestled with myself whether or not I would accompany my brother. 

I should see him. No, I shouldn’t. He probably doesn’t even want visitors. No, he’s Don — of course, he wants visitors. No, I don’t want to remember him that way. Ah, what do I do…

I tried to justify not visiting Don by telling myself that he likely wouldn’t even recognize me in a mask, or that he’d be too weak for visitors, or something else—anything to hide the truth: I was terrified that seeing this version of him — Dying Don — would shatter my image of the Don I knew and cherished. I didn’t end up visiting him with my brother in that instance due to sheer logistics, but that didn’t remove the option of visiting him from the table. 

In an odd twist of fate, we all received this news around the same weekend that was Don’s birthday — likely his last birthday. Pandemic precautions meant no usual party, but Don’s sons arranged a drive-by birthday celebration. I felt better about this — I’d get a little bit of closure out of actually going to see him...without actually visiting with him. My version of Don could remain intact. 

Before the drive-by party, my parents drove over to my house. We all decorated our cars with birthday greetings. Posters held firmly to the sides and fronts of our cars with masking tape read sayings like “Wild Man Don!” with a cartoon portrayal of him in his prized Jeep and other greetings covered our cars. We met up with a good dozen or more cars covered in signs and balloons with mask-wearing friends and family of Don. 

As we approached Don’s house, his sons had pushed him outside in his wheelchair to his porch and wrapped him like a burrito in a blanket, topped with a stocking cap. As the parade honking of cars made their way past Don’s house, they would slow to a near stop to wave and proclaim their birthday wishes. Don, though obviously very weak, cold, and thinner than I’d ever seen him, was grinning from ear to ear. 

Our car was up next. I briefly stopped my car with myself, my wife, and our sleeping toddler son in front of Don’s house and stopped to honk and wave. As I waved and yelled out happy birthday wishes, I noticed Don’s eyes squint to try and make out who this person was. Soon after squinting, his eyes shot open wider than I’d ever seen them in life with a smile that revealed every tooth in his mouth. 

“KENNY!” he exclaimed—not only my name but my nickname only reserved for family and the closest of friends. Most people knew me as simply as Ken. His ecstatic face almost made me think he was about to throw off his oversized blanket and run over to the driver’s side window of my door and hug me through the window.
 

“Wow...Kenny!” he said, eyes returning to their normal size with a sleepy grin. He settled back in his wheelchair as I let the next car approach. 

As the cars pulled down the street, we soon realized that this was a dead-end and that we’d have to pull back around and pass Don’s house again. Some cars went by and then on their way. Others pulled over. I followed my parent’s lead and pulled in behind them. Many of Don’s family members got out of their cars and began to gather in his front yard — all spaced out and wearing masks — to sing happy birthday to Don. Others sang from their cars on the streets. I thought I would be among these people until Don made a special request. 

“I want to see Amir” - my sleeping toddler in the back seat. Not about to deny the request of a dying man on his birthday, I gathered the snoozing Amir from his car seat. Donning a mask and 30-pounds of snoring toddler, I walked up to Don’s stoop — staying around a dozen feet away. 

Don’s face softened with a smile as though he was listening to a favorite song as he gazed upon Amir’s sleeping face — a face he’d not seen in over a year or longer. Don’s eyes then lifted from Amir’s eyes to my own — falling upon them like a warm hug from four yards away. 

“Man, am I glad to see you,” he said to me with a gentle smile, repeating the words I’d said to him that victorious night in that dimly-lit downtown bar.

“I’m glad to see you, too.” 

The Don I knew was still there. The Don I know will always be there, and nothing will ever change that.

Author's note: Don passed away just a few weeks after this piece was written. May his memory be a blessing to us all. 

Hospice & Palliative Care to the Greater Tulsa Area

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Helping care for loved ones with dementia often means attempting to manage their challenging behaviors. Often, the tiniest actions or changes in their environment can trigger negative reactions. In this piece, we’re going to look at how to begin to determine these triggers and spot patterns that will help you prevent negative behaviors. 

Document the Clues Before Attempting to Analyze Them

Like investigating the scene of an accident, it is important to initially put aside theories or hunches about what caused a particular behavior. Instead, simply document the who, what, where, and when details that will help you determine the why. 

You may want to take out a notepad or start a note on your mobile device to work through this process.

Step 1: Document the Behavior in Detail

Before we begin to backtrack to the trigger of the behavior, it’s important to document the behavior in detail. Think as though you were reporting the details of an incident you witnessed to the authorities. 

Who: Who was present when the behavior began? 

What: What happened around your loved one? What specifically did they say? What did they do? What did other people do? What did you do or say in response? Did that help or did it make matters worse?

Where: Where did the behavior take place? Which room? Which part of that room? Which pieces of furniture were nearby? 

When: When did this occur? What day of the week? What time of that day? How frequently does this occur? How long does it last? 

Now that you have the behavior or incident thoroughly documented, it’s time to do a similar practice of chronicling the moments leading up to that behavior. 

Step 2: Document the Moments Before The Moment

Make a similar log of precisely what was happening the moments before the behavior was triggered. Paint the scene of the moments leading up to the negative behavior.

• Where were particular items in the environment placed? 
• What was your loved one doing? 
• What other things were happening nearby?

Step 3: Look For Patterns

Look at all of the data you have collected and scenes you have painted. Instead of thinking about it from your perspective, look at the details from their perspective. Look for the patterns in what has changed. What may have changed from one moment to the next? Are these changes similar to each other before an incident occurs? 

Step 4: Test Your Theories

By now, you’ll likely begin to have theories or hunches about what may be causing the behavior. If you’re having trouble seeing the triggers, remember to look at the scenes you’ve painted from their perspective. Doing so may help you identify something you overlooked because it seemed insignificant to your unimpaired mind.

Once you have a few ideas about what may be triggering these patterns, you can carefully test these hunches by removing what you suspect to be triggering these behaviors. 

Once you remove or change these triggers, carefully monitor how your loved one responds. Don’t be surprised if the trigger was something seemingly insignificant or even silly.

Do they no longer have those loud outbursts? 

Do they still respond, but differently?

Does their behavior actually get worse? (This is still useful information.) 

Continue to monitor their reactions to changing triggers.

Even if you discover the trigger for your loved one’s negative behavior, it’s important to continue to remain perceptive to their reactions. Once you’ve isolated several different triggers for negative behavior, you will likely begin to spot patterns in these triggers that will help you prevent negative behaviors before they occur. 

You Have Friends That Care

For additional resources or assistance in caring for loved ones with dementia toward the end of life, your friends at Cura HPC Hospice & Palliative care are here for you. 

You’re invited to learn more about Cura HPC today.

So, you’re helping care for a loved one with dementia. As you know, their behavior can border from pleasant to downright hostile. Most misbehavior is due to their own confusion, so it can be challenging to correct this behavior. Still, we can’t just let them act out, can we? No, but we can reduce instances of misbehavior in two ways. 

Tactic 1: Opt for diversion in place of head-on confrontation.  

While there’s nothing wrong with asking a loved one to cease an unhelpful behavior, there’s no reason why such correction should become a confrontation. Becoming stern, impatient, or visibly annoyed with a dementia patient will only escalate tensions. Instead, attempt to divert attention away from the misbehavior.

Tactic 2: Remove the factors that contribute to misbehavior. 

If addressing misbehavior to someone with dementia fixed the issue, that’s great! Unfortunately, this is rarely effective in the long term. While usually not spiteful, a loved one experiencing cognitive decline either (a) won’t remember that you asked them not to do something or (b) won’t realize that they’re even doing what they’re doing. 

So, what can you do? Remove the obstacle. 

Let’s say that the dementia patient you’re caring for has a bad habit of automatically throwing away all their mail as though it’s junk mail. Maybe they had a habit of throwing out junk mail before, but now important bills and letters wind up in the trash. Instead of scolding them about this behavior, you can make sure that all mail goes through you before it ever gets to them. By doing this, you remove the likelihood that they can throw unopened mail away and remove a potential negative encounter with them. 

Have a reason for your environmental change ready. 

If you have changed the environment to reduce the likelihood of bad behavior (for example, you get the mail from the mailbox instead of them), the person may ask why the change has taken place. Instead of telling them that you’re doing so because of their misbehavior, have another reason ready. Perhaps, say that you enjoy getting the mail or receiving something that they don’t—some form of coupons they treat as junk mail, etc. Choose an excuse to defuse any confrontations preemptively. 

Preserve the Positivity

Though we may feel more like parents to children than caregivers to loved ones with dementia, it’s important to remember that this is not the dynamic to foster. These are not children who learn from their mistakes and can be told what to do. These are adults who deserve a semblance of autonomy while likely not capable of retaining the information you give them. To preserve the positivity in their home or care center, the best approach is to reduce the opportunity for bad behaviors to occur in the first place. In this way, you can avoid difficult conversations and negative emotions.

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The Confusing Relationship Between Hospice and Heart Disease

Could heart disease patients benefit from hospice services and when? 

Because hospice services are usually recommended by a physician when all treatment avenues are have been expended, and a patient is expected only to live an additional year, six months, or less, heart disease can make matters complicated for all involved. 

When is hospice right for heart disease patients? 

Though one may receive a diagnosis of severe heart disease, determining when heart failure will ultimately take their life is difficult, if not impossible. Due to heart disease’s complex nature, only a physician can determine if hospice services are the best next choice.

What are some signs that a heart disease patient may be considered for hospice? 

Though rare, it’s not unheard of for a physician to recommend hospice services for a patient who has a combination of the following signs: 

• Advanced coronary disease with bouts of severe chest pain due to angina
• Has expended all surgical options for treatment
• Has personally decided not to opt for any additional treatments

Why would hospice be the right choice for those with a terminal heart condition? 

When all treatments aimed at recovery from heart disease have been expended, hospice care can help these patients find more day-to-day comfort than they may have ordinarily received toward the end of their life. This care includes management of their pain, shortness of breath, and other persistent discomforts. At times, managing these symptoms in lieu of aggressive attempts at curative treatments actually result in fewer instances of hospitalization and an overall higher quality of life. 

Many loved ones and patients of advanced heart disease who were ultimately forced to undergo hospice services in the last few days of life claim they wish they had sought out hospice care much sooner. 

Palliative and Hospice Care in the Greater Tulsa, Oklahoma Area

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1. There’s not a single dementia staging model. 

Staging one’s level or stage of dementia can be immensely difficult due to not only the various types of dementia but also the different staging models that may exist per dementia type. For the sake of clear communication between caregivers and family, it is crucial to determine which staging model will be implemented. Which staging model is to be followed should ideally be determined by a physician. Upon dementia diagnosis, feel free to ask which staging model will be utilized and how stages will be determined going forward according to this model. 

2. A dementia patient may seem to flow between stages. 

One of the most confusing aspects of dementia is the day-to-day mental state of the patient. Depending on the style of dementia, several days of intense confusion may be followed by days of apparent clarity and a return to one’s “old self.” While days of clarity should be cherished, treating them as a symptom of improvement may be emotionally precarious for loved ones. These good days following bad days can be a bit of a rollercoaster, so it is important for loved ones and caregivers to “zoom out”—determining the state of a patient’s wellbeing by taking an average of a month or even several months to gauge their condition—not one day to the next. 

3. There’s no set time per stage for patients. 

It’s not wise to estimate just how long it will take a dementia patient to move from one stage to the next. Too many variables exist that can speed up or slow down the rate of dementia stage progression. The type of dementia, specific age, activity, socialization, and even one’s diet can impact one’s time in a particular stage of dementia. No one can put a particular date on the rate of progression of one’s dementia.

4. There’s no singular symptom used in staging. 

As much as one would like a clear sign that their loved one has moved from one stage of dementia to another, that’s not necessarily how staging works. Instead, specialists look at a range of symptoms, their frequency, and many other factors to determine the stage of a patient’s dementia. While confusing for loved ones, this may actually provide a bit of hope for those who have already assumed an extremely late stage due to one or two specific symptoms. No two cases are identical, and no two timelines are the same. 

Palliative and Hospice Care in the Greater Tulsa, Oklahoma Area

If you’re looking for nurturing and professional hospice or palliative care services in Tulsa, Oklahoma, look no further than the friendly assistance from Cura HPA Hospice & Palliative Care.

With the approaching holiday season or anytime travel is necessary for a loved one with dementia, preparation is key. For this piece, we’re going to cover how you can prepare them as well as yourself for this undertaking. 

Preparing Your Loved One with Dementia for Travel 

Assemble What They May Need 

While it’s important to never compare traveling with a child to the experience of traveling with an adult with cognitive decline, there are some similarities that may make preparing to travel with them easier for you. For this, you will need to simply sit and imagine all possible scenarios and make a list of items that would make the experience easier for them. This may include a change of clothes in case of any messes, items that will help them feel calm, or favorite snacks. It’s also a good idea to keep a list of their doctors’ phone numbers and their medications handy in case you need them on your journey.  

Assemble Safety Items 

Because dementia patients deal best with the familiar routines of life, new experiences of traveling can be quite difficult for them. In addition to keeping items handy that will calm them down, make sure that they possess some form of wearable identification at all times. Usually, a bracelet with their name, condition, and your phone number is helpful in case you become separated for any reason. This sounds unnecessary as you never plan to be away from them, however, if they become lost in an airport terminal, travel stop, or other place, someone else’s ability to contact you is critical.  

Preparing Yourself for Traveling with a Dementia Patient 

Expect the Best. Plan for the Worst.  

There’s no reason to let a loved one’s condition give you immense anxiety about traveling with them. With this being said, planning for almost any scenario will help you to respond instead of reacting impulsively. Imagine potentially difficult moments and plan how you will respond beforehand. This can help you prepare to act stoically and think rationally when emotions run high. 

Plan For Interactions With Others 

Interacting with new people on your travels can be both a blessing as well as a curse. The blessing may be meeting new people who share their experiences. The curse may be that these people may not understand what your loved one or you are presently experiencing and may not be as sensitive. For this reason, it’s important to plan how you respond to these people if your loved one has any form of an inadvertent incident that draws attention to them or offends others.  

One approach is to simply not care about what others think—your loved one can’t help much of their negative behavior and you will likely never see this stranger ever again. Another approach, especially handy when time is short, is keeping a small stack of cards in your pocket that explains that your loved one has dementia and certainly did not intend to offend them. Whether you choose to inform strangers of the reason for your loved one’s possible outburst or not, it’s important that you remember that their reaction doesn’t matter nearly as much as your own response to the situation. 

Though traveling may be difficult with a loved one suffering from dementia, the greatest gift you can give yourself in these moments is to be fully present with them every step of the way.  

Hospice & Palliative Care in Tulsa, OK 

If you’re looking for nurturing and professional hospice or palliative care services in Tulsa, Oklahoma, look no further than the friendly services from Cura HPA Hospice & Palliative Care.

Though less common, parents who have lost children are never alone. 

The death of a child is among the most severe forms of grief one can experience. While grieving the loss of an adult in one’s life is difficult (a sibling, spouse, parent, grandparent, etc.), the child-to-parent relationship can make such a loss especially devastating. There are many unique emotions and stages to grieving the loss of a child. It can be helpful to understand these emotions so that they can be processed in a healthy way. 

Some Common Emotions

The Feeling of Failure

Despite the cause of death, many parents will feel a tremendous sense of guilt or failure to protect their child from harm. Though accidental deaths are most likely to result in the feeling of failure, even terminal illness can make parents feel like they have failed to do enough to keep their children healthy. These emotions stem from the innate sense of duty that devoted parents feel to safeguard their children from all threats. 

Anger or Injustice

Between instances of grief, anger may trail close behind. Despite a parent’s spiritual outlook or worldview, many can’t help but experience a sense that an injustice has occurred—that their child has not only died but has been taken from them, a fate that this child did nothing to deserve. This anger may be projected towards a societal structure, a divine being, or even themselves. Though this emotion can overtake a person, it can potentially be helpfully redirected towards growth—perhaps towards a good cause or communal initiative. 

Anxiety About the Future

Some people who have never experienced anxiety before—a dread of the future—will suddenly develop such sensations following the death of a child, especially if such a passing occurred suddenly. This anxiety may be in regard to how they will feel in the future or how others will treat them. Some parents may grow withdrawn so as not to have to face either the pity or the judgment of other people. 

Helpful Grief & Recovery Methods

Gracious Reflection

A form of emotional salve for many grieving parents is cultivating a sense of gratitude for the time they spent with their children. Reflecting on positive and tender moments instead of the tragedy of their passing can help in transforming their memory into a blessing. Meditating on the positive impact the child had on the parents’ lives can help transform pain into gratitude.

Remembering to Care For One’s Self

Grief can consume one’s focus on their own personal maintenance. Getting back into the swing of taking care of one’s family and one’s self can help provide much-needed momentum in the face of negative emotions. This shouldn’t be thought of so much as a distraction from grief, but rather a means of processing grief through action.

Communicating & Processing Grief With Others

While most will experience the death of a parent, grandparent, or even spouse, not everyone will lose a child. The perceived abnormality of the situation can make someone feel isolated—that no one understands what they’re experiencing or that worse, that others will judge them. Thankfully, most every town or city has a variety of specialized support groups for grieving parents. In these groups, grieving parents can meet and speak with other grieving parents to share their emotions and build a sense of community around shared loss. Many parents who have lost a child report that the decision to join a support group was, in fact, a game-changer on their road to healing. 

Not Feeling the Need to Stick to a Timeline

Though there are average durations for the many stages of grief, none of these are exact or recommended to follow for the proper processing of grief. A grieving parent should not feel anxiety over their own inability to “move on” as quickly as others may have. Everyone is different and some people simply need more time. It is important, however, to believe what many grieving parents have reported—that the pain grows less severe over time and that the blessing of the child’s memory overshadows the tragedy of their passing. 

Hospice & Palliative Care in Tulsa, OK

For the highest quality hospice and palliative care services, Cura HPC Hospice & Palliative Care is proud to serve the families of Tulsa, OK. Learn more about Cura HPC today.

Many equate “hospice” with a form of care for a person with a terminal prognosis—typically with the last 6-month window of their life. For this reason, this care may be recommended when other forms of care have been deemed ineffective at lengthening the patient’s life in a meaningful way. Hospice care is meant to provide the individual with comfort and dignity before they eventually pass away. With this being said, the path to patient discharge is not always as “simple” as that. 

Patients Can Seem to “Improve”

Though rare, there are instances of hospice patients seeming to do much “better” in hospice care than traditional hospitalization or while receiving other forms of care. They may become more alert, more social, and happier. This does not necessarily denote a recovery but can occur due to a variety of reasons. At times, as one’s plan of care shifts as they move from traditional care to hospice care, this can mean changes in their medications, diet, social interaction, and the like. In most instances, even these positive changes are not indications of the possibility of recovery but are more likely due to various positive aspects of hospice care—especially in comparison to receiving taxing treatments leading up to a referral. 

Does Anyone Ever Recover After Entering Hospice?

The decision to refer a patient to hospice care is not one entered into lightly. For this reason, most patients who elect for this care do not recover from their terminal diagnosis. It is important to note, however, that patients or family members can choose to revoke hospice care at any time if a physician has determined the possibility of a treatment that can lengthen the patient’s life longer than the previous length of time. While this can happen, this is highly unusual and should not be expected. In most instances, holding onto such false hopes following a hospice referral can be emotionally taxing for patients and family members alike. 

More Questions About Hospice Care?

If you or a loved one have additional questions about hospice care, feel free to reach out to the experts at Cura HPC Hospice & Palliative Care in Tulsa, OK.

Whenever the subject of hospice comes up for families, it may seem uncomfortable to ask the question that may also be on one’s mind— 

“Well, who is going to pay for this?” 

How Hospice is Covered in the United States

As your family begins researching what is covered in end-of-life care for a loved one, the cost of care does not need to be a further worry. For this reason, it will likely be reassuring to discover that, in the United States, most hospice care is completely covered by Medicaid, Medicare, Veterans Administration plans, or most major insurance plans. 

How Can Insurance Afford This Expense? 

It may seem peculiar that most forms of insurance cover hospice care. The reason for this is because, in comparison to the cost of repeated lengthy hospitalizations, hospice is relatively inexpensive to administer. This lower cost makes covering such care easier for most insurance companies.

How Much of Hospice is Typically Covered?

Due to the lowered cost of administration in comparison to many forms of healthcare, most insurance plans, Medicare, or Medicaid will cover most all end-of-life care. These items include the cost of medication and other related expenses. 

What About Uninsured Hospice Patients? 

There are occasions when, for one reason or another, a patient cannot afford major insurance coverage and does not qualify for Medicare or Medicaid. When this is the case, a financial advisor working on behalf of a hospice organization or a non-profit organization can assist patients and their families in securing funding.

Additional Questions? 

No two scenarios are identical, and prices may vary depending on a variety of situations. For this reason, if your family has any questions about paying for hospice care, you’re encouraged to reach out to hospice care professionals in your area. 

Quality Hospice & Palliative Care in Tulsa, OK

For quality hospice care in the Tulsa, Oklahoma area, you’re invited to learn about Cura HPC Hospice & Palliative Care.

Surprises can be fun. A surprise birthday party can be an unexpected joy. A surprise in the plot of a movie can add a suspenseful twist. When it comes to the health or longevity of a loved one, however, surprises can be unbearable. For this reason, many family members of hospice patients have been known to ask hospice nurses or doctors, “How much time do they have left?” While a specific month, week, day, or hour amount is helpful for families so they can emotionally prepare, in many instances, hospice care professionals won’t deliver a specific answer. 

The Variables

As much as families would like one, there is no hourglass whose sands count down the moments of life their loved one has left. Doctors and nurses can make estimations based on their own experiences with past patients who displayed similar symptoms or experienced the same conditions. Still, these are simply educated guesses based on one’s own experience, not a bedside hourglass. There are myriad reasons why some people live longer and some pass away sooner than others. 

The Danger in Overestimating

Another reason why hospice nurses and doctors may be hesitant about providing answers based on their experiences is the severe danger in overestimating the patients’ longevity. It’s understood that those administered to hospice care could pass at any time. Some may continue living long past the doctors’ furthest estimations. Others could pass away in their sleep soon after arriving. When a hospice nurse or doctor provides an estimate that spans a fair amount of time out and the patient dies much earlier than this expected time, the surprise can be devastating for family members and loved ones. For this reason, many hospice professionals will resist the temptation to deliver an overly specific estimation regarding a patient’s lifespan. 

The Safe Answer

Despite this apprehension over delivering an incredibly specific lifespan estimation, hospice professionals will still give patient families and loved ones reasonably safe-but-accurate input into their conditions when asked. An experienced hospice nurse or doctor may be able to tell loved ones whether a patient has hours to days, days to weeks, weeks to months, or months to years left. This may be all the information they can reliably give, but is still specific enough to help loved ones emotionally prepare for the loss of this individual. Of course, these standards will vary depending on the hospice professional, the patient, and their ongoing rate of decline. 

They’re Not Lying to You

With whatever answer you receive from your hospice care professional, it is essential to know that no one is lying to you. There is no incentive for anyone to be deceptive about the lifespan of a patient. What may feel like secrecy is likely uncertainty—none of which is anyone’s fault, but simply the complicated nature of patient decline. It is vital to trust your loved one’s hospice care professionals and believe they are doing everything in their power to provide comfort, clarity, and honesty throughout the process.

No matter their specialty, nurses are some of the most wonderful people to walk the earth. The combination of proficiency, professionalism, focus, and heart that goes into being a nurse is what makes the role such a highly regarded position by patients, families, and other medical support staff. There is one kind of nurse, however, that is arguably different than any other variety of nurse—the hospice nurse. While we’re not attempting to say that hospice nurses are better than other types of nurses, the role does require a very unique kind of person. In this piece, we’re going to look at some of the reasons why hospice nurses are such a special subset of professionals within the nursing profession. 

Hospice Nurses Have an Adaptive Pace

To say that hospice care centers differ from other healthcare establishments is an understatement. Where the goals of most hospitals and clinics are to help restore the patient back to health as quickly as possible, hospice aims to provide the maximum amount of comfort as to patients and assist them through the dying process. Because of this, the daily pace of a hospice nurse differs significantly from other healthcare professionals. A hospice nurse’s pace must mirror the pace of the patient. Determining this pace is a unique skill that experienced hospice nurses develop over time. 

Communication With Patient Families

While nurses across the medical field must be master communicators, hospice nurses have the immense task of communicating the particulars of a hospice patient’s status with family members. Family members of hospice patients are justifiably emotional and in need of answers. Choosing the right words to deliver certain pieces of information accurately, yet not harsh, is a skill less taught and more developed with years in hospice care. To make matters more difficult, hospice nurses are frequently asked point-blank questions about a patients’ life expectancy and other variables. In many of these instances, there are no precise answers to deliver, but the proper feedback must be given regardless. 

Hospice Nurses Are Champion Listeners

In addition to caring for the physical needs of hospice patients, hospice nurses have a unique superpower—listening. There may be times when hospice nurses have no answers for patients or family members alike. What they will have to give is a caring ear. The slower pace of hospice care allows nurses the unique opportunity to lend an ear and help shoulder emotions from patients and loved ones alike. 

Hospices Have to be Tough

Being a hospice nurse isn’t easy. One would think that they would have to remain in a bubble to keep from growing emotionally attached to a patient in the dying process. While this would be a safer way to work, they don’t—they allow themselves to be vulnerable and fully embrace their patients as people deserving of such respect. While this is understandably painful for them, they understand that being vulnerable is the only way to deliver the level of care necessary for their patients. Though they may shed a tear along with loved ones, they can return to work to the next day knowing that they gave their all in helping their patient navigate the dying process. Many attempt to be hospice nurses, but can’t handle the constant loss that comes with the job. While this is unfortunate, it means that those who remain are truly giving their all. 

The world, as most of us know it, has changed due to the COVID-19 pandemic. Hospice and palliative care professionals are also taking the steps necessary to ensure the safety of patients and care staff alike. The following is a relatively broad overview of some of the changes that have occurred across the hospice and palliative care industries. Some of these changes may differ based on different organizational protocols, local ordinances, and the rate of infection over time.

Minimizing Patient Exposure

Many new policies have been put in place in an attempt to limit patient exposure to possible carriers of the COVID-19 coronavirus. Some of these new rules include limiting specialist traffic through patient homes and care facilities. While doctors, registered nurses, and other specialists deemed officially “necessary” to patient care are allowed careful access, many others are now barred from physically accessing these facilities or patient homes. Most social workers, certain therapists, chaplains, and visitors must now communicate with patients and their families via video conferencing or some other form of telecommunication. 

To further minimize possible virus spread within facilities, most specialists are screened for infection before beginning work. This screening process includes a comprehensive questionnaire about their past whereabouts, behaviors, and with whom they have come in contact. Their temperatures are also taken to detect possible fever. 

Face Masks

Due to the ease of transmission of the COVID-19 coronavirus from respiratory droplets, most caretakers are required to wear masks that cover their nose and mouths while working with patients. Most of these masks are likely surgical facemasks, though some may wear cloth facemasks where surgical facemasks are in shorter supply. 

Those Working With Infected Patients

For patients who have tested positive for the COVID-19, entirely different protocols apply. Staff members caring for such patients (where they exist) are required to don the appropriate personal protective equipment—including custom-fitted N95 facemasks.

Video Conferencing

Though communication with patients is important, most interactions with patients and their families, chaplains, therapists, or social workers will continue to take place via video conferencing to limit the patient’s exposure risk.

Like you, we can’t wait for this pandemic to be behind us and for regular visitation to resume. However, for the sake of patient and staff health, we must remain vigilant. We’re all in this together. 

Related Articles

• • Abridge: Never Miss Your Doctor’s Feedback Again
  • The Role of a Hospice Chaplain
  • Difficult Decisions Associated with End-Of-Life Dementia
  • The Value of Practical Tasks for The Dying

There are various ways that hospice care differs from standard treatment in hospitals or other medical centers. The primary difference is the aim of the care. Much of the medicines in hospitals are prescribed to successfully treat the patient’s condition and even bring about recovery. This care may result in some treatments that come with adverse side effects. On the other hand, hospice care is typically recommended when it is evident that the patient will likely succumb to their condition within the next six months. 

Because treatment of the patient’s condition has been all but suspended, there may be fairly significant changes to their regular medications. 

Hospital Medications

A patient’s main medications in a hospital setting are in an attempt to treat their condition. These medications may have adverse side-effects, many of which are treated with secondary medicines. An example of this may be chemotherapy, which is known to have immensely harmful side-effects. Secondary medications may be administered to alleviate such side-effects, such as anti-nausea drugs and the like. 

Hospice Medications

Most medications administered to hospice patients are not intended to treat an illness, but rather to alleviate discomfort. Some of the more common drugs are morphine (used to relieve pain and to steady breathing), Lorazepam (used to treat anxiety and agitation), Levsin (used as a drying agent to prevent the build-up of excess fluid in the back of the throat), and Haldol (used to treat agitation and nausea). Many other medications may be used for similar purposes, depending on the needs and sensitivities of the patient. 

No two patients are the same, making careful dosage considerations crucial for quality hospice care. Doctors, specialized hospice nurses, and any other caretakers must work together to ensure optimum care for hospice patients. 

Related Articles

• Types of Physical Discomfort Among the Dying
• Does Morphine Hasten the Dying Process?
• Pain Management in Palliative Care
• Loss of Appetite When Dying Explained

Spending one’s last days at home used to be a prevalent situation. Unfortunately, since the 1960s, hospital ICUs have become the most commonplace for people to spend their final moments. However, with advances in technologies and attitudes, the “luxury” of being able to receive hospice or palliative care at home is once again returning to the mainstream. While this is good news for hospice patients and those closest to them, a proper home hospice setup is a crucial aspect of delivering quality care. 

Determining the Best Course of Action

Before home hospice can take place, the arrangement needs to be approved and reviewed by attending medical professionals. If the patient has intense or unique care needs, home hospice or palliative care may not be possible. Not only will the attending medical professionals need to sign off on a home hospice arrangement, but they will also be integral to developing the best home care plan possible.

Limiting Hazards for Patients & Caregivers Alike

To provide the patient with the most excellent care, caregivers must be given the most optimal workplace possible. Though patient comfort is of the utmost concern with a home hospice or palliative care setup, providing this comfort will be more difficult for caregivers if a home hospice space is unnecessarily cluttered. This means that all unnecessary tripping hazards (rugs, items, etc.) or inhibitive accessories (unnecessary furniture, hanging lights, etc.) must be removed from the care spaces. 

Preparing the Bedroom

The bedroom will be one of the most crucial sections of the house for optimal patient care. As mobility declines, more and more attention will be administered from this space. Because of the limited mobility as well as confined space, a typical hospital bed is recommended. If the bedroom space is not ample enough to accommodate a hospital bed and all of the necessary care equipment, a larger room may be selected as the place where the bed will reside. Some options may include a den, front room, or even a living room.

Bathroom Safety

For the safety and comfort of patients, easy access to the home’s bathroom is crucial. Once in the bathroom, new hazards emerge. Because more slips and falls occur in the bathroom than anywhere else in the house of someone with unique needs, non-slip mats, handrails, heightened toilet seats, and shower chairs must be installed. Any bathroom used by the patient should be able to accommodate all of the medical accessories and needs. 

Keeping Home Cozy

There’s little use in allowing a hospice or palliative care patient access to home care if their home doesn’t feel as such. To keep the home feeling like a home rather than a hospital room in their house, comfort-inducing touches are essential. A patient’s favorite activities should be easily accessible—this includes access to games, books, pictures, keepsakes, television, a computer, telephone, and the like. When possible, their own favorite pillows, blankets, and furniture should be utilized when their need arises. 

Accessible Care Plans

There’s a good chance that multiple caretakers will be tasked with caring for an at-home hospice or palliative care patient. These various caretakers will need to work in sync with one another to provide consistent care. To facilitate this partnership, a care folder or plan should exist within the home in an accessible place. Ideally, this place within the house should be dedicated to managing the patient’s at-home care. The folder in this area should contain documents that outline the patient’s needs, emergency contact information, medication schedules, meal plans, and anything else needed to ensure patient comfort. 

The goal of home hospice and palliative care is not a hospital room disguised as a home, but a home that can still accommodate all of a patient’s medical needs. 

All of this possible from the friendly professionals serving Greater Tulsa, OK at Cura HPC Hospice & Palliative Care.

Just Try Not to Smile

You’ve likely experienced a moment of joy that comes when man’s best friend suddenly visits you. Whether a dog belongs to a friend or is a joyful pooch with a stranger holding its leash, there seems to be a kind of magic that comes with interacting with a well-behaved dog. Well, oddly enough, it’s not magic—it’s science. In this piece, we’re going to look at the why and how of using therapy dogs to increase hospice patient happiness and health.

Dogs Remove Someone From Their Environment

For many hospice patients, their lives have not been optimal for many months or possibly even many years. They’ve likely undergone many procedures or therapies and spent their fair share of time in a treatment center. While healthcare providers do their best to make patient stays as comfortable as possible, there are few ways to avoid the discomforts of actively receiving treatment for what is likely a failing body. For this reason, a visit from a therapy dog is one of the more welcomed escapes hospice patients can experience. Because one doesn’t ordinarily associate a snuggly furry friend with receiving treatment, the simple presence of a therapy dog allows a hospice patient a reprieve from their anxieties and discomforts. 

Memories of the Past

Reminiscing and sharing positive memories are activities frequently encouraged to families of hospice patients. While going through photo albums or home movies are immensely beneficial ways to increase patient happiness, interacting with a therapy dog can have an astounding ability to help hospice patients recall moments with pets they’ve enjoyed. Memories of beloved pets can be some of the most joyful memories we can remember, and there are few other memory joggers quite like the wagging tail of canine companion. 

The Power of Touch

While a photo album can trigger immense joy and a favorite story can transport someone to the day the events occurred, physical contact has been clinically proven to put us at ease. In studies, patients interacting with therapy animals showed spikes in oxytocin, serotonin, and prolactin—hormones associated with calmness, comfort, and happiness. Whether the connection is the embrace of a friend or the gentle petting of the floppy ears of a golden retriever, this contact with a companion is shown to lower one’s blood pressure and help reduce anxiety.

The Furry Pain Reliever

While most would equate a visit from a friendly therapy dog to increase happiness, these encounters have even been shown to reduce sensations of physical pain. While results may vary, positive encounters with therapy dogs and hospice patients have resulted in pain reductions, lowered blood pressure, and improved cardiovascular conditions. Best of all, these furry pain relievers have no adverse side effects aside from light shedding and the occasional slobber. 

The Benefits of Joyful Expectation

One of the greatest despairs facing hospice patients is the idea of not having many joys in which to look forward. For this reason, visits from therapy dogs provide hospice patients with hopeful expectations even when they’re not around. When a hospice patient is informed that a therapy dog is coming to see them, this news by itself can fill them with joyful anticipation. 

Hospice & Palliative Care Services in Tulsa, OK

For those exploring the highest quality hospice and palliative care options in the Greater Tulsa, OK area for themselves or a loved one, you're invited to meet the friendly hospice care professionals from Cura HPC.

Learn more about Cura HPC today. 

Throughout our lives, we serve many functions and purposes. Sibling, friend, teammate, spouse, parent, teacher, manager, counselor, muse—the list goes on. Once we die, outside of memories, our purpose seems to end...but it doesn’t necessarily have to. Yes, we can serve an immensely beneficial purpose once we die through a program called “whole body donation.”

What is Whole Body Donation?

Whole-body donation is the arranged act of donating one’s body “to science” after death. Once someone dies, their bodies are immediately transported from the site of death to the medical school of their choice or following funeral services. Bodies donated to medical schools are used for educational purposes for both medical students as well as experienced doctors for continuing education or surgical training.

Why Should I Consider Whole Body Donation?

No Substitution for a Real Body

Modern technological innovation in the sphere of medical training and research has made incredible strides in the development of educational tools and materials. Though this is the case, there is no educational substitution for a real human body. For aspiring doctors, many consider the body used to help them learn an array of functions to be their first patient. One cadaver can provide incredible insights about the human body that will help a doctor throughout their career. Other bodies donated for continued surgical training for experienced doctors will reduce the number of treatment errors for living patients. The educational input provided by one donated body can save countless lives over the careers of these doctors.

Cost Saving Measure for Final Resting

If losing a loved one wasn’t hard enough, funerals, cremations, and burials are among some of the most expensive services most of us will ever pay for. According to Parting.com, the average North American funeral and burial cost anywhere from $7,000-$10,000. Though medical schools do not pay for bodies donated to their institutions in keeping with Federal law, most will cover the costs associated with laying to rest the donated bodies. Though the remains of most donated bodies are cremated, special arrangements can be made for the remains to be buried. This option may vary depending on the chosen institution.

How to Elect for Whole Body Donation

If you or a loved one are interested in donating your body to science, it is encouraged that you contact the medical school of your choice directly. This recommendation is to eliminate the chances of the improper usage of a donated body by a third-party intermediary service. Medical schools that accept donated bodies strive to make the body donation process as easy as possible for the next of kin. The department responsible for receiving donated bodies can help families make the necessary legal and administrative arrangements that will ensure a stress-free donation process. To further streamline the process and remove complications, arrangements should be made ahead of time as much as possible.

Who is Eligible for Body Donation?

There exists a common misconception that someone who is incredibly old or who experienced a traumatic disease cannot donate their body to science. Though some bodies will be denied from the program, these typically only include rare instances—possible communicable disease, extreme obesity, autopsy, or other reasons a body cannot be used for education purposes. Individual medical institutions set the criteria for donation eligibility.

Will My Body Be Treated With Respect?

Though most medical institutions cannot disclose the specific use of each donated body, they can assure family members that their loved one’s remains are treated with the utmost respect. Despite possible dissections or surgical training sessions, all honor and dignity possible are granted from the moment a body is received until it has adequately served its purpose and is ready for cremation or burial. Students are typically “introduced” to their assigned cadaver as one might meet a study partner. Many institutions have a concluding ceremony to honor those who have donated their bodies. Some students write thank-you letters to the families of those who have given their bodies. The entire process is treated with the highest honor, dignity, and respect.

Whole Body Donation in Oklahoma

If you’re interested in whole-body donation in Oklahoma, here are a few helpful links to help you begin the process.

Willed Body Program - OU Medicine

• https://www.oumedicine.com/college-of-medicine/information-about/office-of-medical-education-(ome)/willed-body-program

Body Donor Program - OSU Medical Center

• Email thom.garrison@okstate.edu or (918) 561-8446

For additional information on quality hospice services serving the Greater Tulsa, OK area, you’re invited to learn about CURA-HPC Hospice & Palliative Care.

The image featured is used from the official website of Abridge. 

Even for those in relatively good health, doctor’s visits can still be nerve-wracking. “White coat syndrome” — appointment-induced anxiety — has been shown to spike a patient’s blood pressure far above what would be considered an accurate reading. Compound these jitters with receiving life-changing feedback and this can make properly digesting a doctor’s explanations and recommendations quite a feat. Fortunately, one mobile device application is taking the stress out of taking accurate notes — Abridge.

How Does it Work?

Abridge is a mobile device application available for free for iOS and Android operating systems. During a doctor’s appointment, a patient, caregiver, or anyone accompanying the patient can open the application and begin recording the doctor’s feedback and answers. This application wouldn’t be very groundbreaking if it were just another audio recording, though. To best serve patients and those caring for them, Abridge also automatically transcribes the conversation, accurately capturing details specific to the healthcare field. Standard transcription services often mistranscribe these anatomical, medicinal, and disease-based terms. Once the appointment is over, the app user only needs to tap the same button they used to start recording, and the program begins to transcribe the conversation automatically. If the app-user so chooses, they can enter additional appointment details and email the discussion and/or transcription anywhere they like directly from the application.

Why Use Abridge?

Even if we’re naturally scatterbrained individuals, when a medical professional is giving us feedback concerning our condition, we strive to be all ears. Despite some of our best efforts, many of us may mishear information or focus on specific details over others. This mishearing may result in missing suggested recommendations, feedback on conditions, or undue anxiety because of miscommunication.

The Importance of Accurate Notes

Sometimes in life, our minds have a funny way of allowing us to “mishear” what is plainly said. Anxiety can cause us to focus on negative feedback disproportionately. Denial can cause us to miss specific details. A patient with their loved one can sit in on the same doctor’s visit, and both claim they heard a report opposite to that of the other person. An accurately transcribed recording of the doctor’s feedback can be immensely helpful for those in emotionally charged medical situations.

Easy Coordination of Care

Most of us who end up needing medical treatment will likely not receive this care from one source or a single individual. A doctor may diagnose an ailment and prescribe therapy or medicine. The visit will need to be covered by a health insurance provider. A prescription will need to be filled by a pharmacy. A nurse may require specific care instructions. If the patient is experiencing dementia, the amount of information a caregiver needs to coordinate alone can be a significant source of anxiety. Proper recording and transcription of doctor and nurse feedback can help caregivers arrange the type of care a beloved patient may need.

If you would like to learn more about Abridge and download the totally free application on your mobile device, proceed to Abridge.com to sign up today.

Cura HPC Hospice & Palliative Care is proud to serve the Tulsa, Oklahoma area.

We are all multifaceted beings with different needs. Attending physicians and caretakers tend to our physical health. Social workers can tend to our mental and emotional health. These are both essential members of a hospice care team. Just as these experienced professionals handle their respective specialties, so too does a hospice chaplain tend to the spiritual and many emotional needs of those receiving hospice care.

Navigating a Spiritual Journey

Towards the end of life, one's spiritual health is a crucial facet of their overall wellbeing. For some, the process of dying can be a confusing part of life that provokes a good deal of anxiety, depression, and even anger. Just as they have in life, many will look to spiritual practices, concepts, and specialists to help quell turbulent emotions and prepare them for death. Hospice chaplains help these patients to navigate their spiritual journey.

Who are Hospice Chaplains?

A hospice chaplain is typically a spiritual cleric of sorts employed by the hospice organization. This person is highly trained and experienced in helping those in hospice care and their families to achieve spiritual peace throughout the dying process. They can provide this peace and comfort by helping to answer questions, providing helpful spiritual wisdom to ease the mind and spirit of the patient by listening. Other times, a hospice chaplain best serves just by being silently present.

Hospice chaplains may be of a specific religious denomination, though most will have an interfaith background to assist patients of varying religious paths. All hospice chaplains are specially trained and experienced in unique challenges and concerns of the dying. Some find they may even be of more comfort to them than their regular chosen clerics.

Who Receives the Care of Hospice Chaplains?

Any hospice patient can request the consultation of a hospice chaplain. Some patients will already have a closer relationship with a non-hospice chaplain, such as a family priest, rabbi, minister, or imam — and may opt to visit with them instead. Other patients may not want any form of spiritual guide, instead opting for the spiritual care of friends and family. Regardless of a patient's religious affiliation or beliefs, hospice chaplains of any background will respect their faith and provide any support within their abilities.

Hospice Chaplains Provide Companionship

There are, unfortunately, some in hospice care with very few or no companions to accompany them on their departure. For these individuals, hospice chaplains fill in the crucial role of companion towards the end of life. Chaplains may also play an essential part in filling in any gap between the patient and the care of hospice caretakers and doctors — ensuring that they leave this world accompanied by a loving and compassionate friend.

How Hospice Chaplains Help Families

The dying process can be emotionally and spiritually difficult for close family and friends. Hospice chaplains also assist those close to hospice patients before, during, and even after the death of a loved one. When needed, family members or companions can consult hospice chaplains long after the death of their loved one to assist them while grieving. For most families, their loved one’s hospice chaplain has a precious place in their hearts for the rest of their lives. 

Meet Our Chaplains

If you or a loved one have any questions about the role of a hospice chaplain, you're welcome to reach out to us. If you're looking for an experienced and compassionate hospice care organization based in Tulsa, Oklahoma, we'd love to introduce you to our experienced hospice chaplains.

Reach out to Cura-HPC Hospice & Palliative Care Today

There are few instances in life more emotionally painful than losing a loved one. Whether they were a family member or a close friend, the death of a cherished person can leave one feeling lost, alone, sad, angry, or even bewildered. Your emotions may be the result of missing the person or upset that they are no longer living. Caretakers may feel especially confounded due to a void — a lack responsibility —  an aimlessness left by the duties that once consumed their energy. Feeling like you’re floating helplessly adrift, sad, or mad — these are normal emotions. Fortunately, there are many ways to help remedy these feelings. 

Don’t Ignore Grief

Because many are ill-equipped to manage feelings associated with grief after the death of a loved one, they feel that merely ignoring these emotions will make them disappear. This attitude is a tremendous mistake — one that may result in all manner of emotional, psychological, and even physical maladies down the road. It is essential to work through feelings of grief. Fortunately, there is a wide selection of grief management techniques and services from which to choose. 

Little Help From My Friends

One of the most potent forms of support can come from mutual family members and friends of the deceased. Not only are these individuals also grieving a loss, but they’re grieving the loss of the same individual. This mutual loss means a greater alignment of timing, feelings, and reference. The idea of sharing stories about this person can seem potentially pain-inducing at first, but you’ll be surprised how comforting these stories can be — as though this person’s essence has come back for a visit. A series of laughs, tears, and even new stories about this person will not only help to ease your grief but will bind you even closer to the fellow mourners of this loved one. 

Grief Counseling

Grief can be a traumatic event in your life. To better manage this pain, to work through your emotions, and begin to live your life again, there’s absolutely no shame in seeking professional help. Regular sessions with a trained therapist is a great way to attain personalized help and work through problems in a deeper, more profound way. Other forms of grief counseling can be via a support group. Support groups are organized through spiritual organizations, community centers, healthcare systems, or even hospice institutions. Some support groups are specialized for those who have lost parents, siblings, spouses, or even children. These shared experiences intensify the bonds among support group members — some of which go on to be lifelong friends. 

Sick With Grief

We all know that grief can leave you breathless, leave a pit in your stomach, or sap you of energy. Though some of these symptoms are purely emotional, severe grief and depression can result in physical sickness. The stress of a significant loss can reduce your appetite, cause you to crave the wrong kinds of foods, incumber sleep, or make you less likely to exercise. Any of these physical conditions can weaken your immune system and leave you more susceptible to viruses or bacterial infections. Yes, overcoming your grief is also a way to maintain your physical wellbeing. 

Hospice: Not Just for the Dying

Did you know that hospice care is more than a service for the dying, but also offer grief counseling services for the living as well? At Cura-HPC, our work isn’t through with the death of a loved one. Our Bereavement Care services extend for a full year past the death of a loved one. That means a person to talk to, a shoulder to cry on, and the hope of a brighter day. 

Learn More About Cura-HPC Today.

It can be easy to forget the terminal nature of Alzheimer’s and Parkinson’s Disease because the patients can sometimes live for many years with such conditions. Caregivers should remember that these will ultimately result in death and that they should plan accordingly.

Difficult Choices

As dementia progresses, the patient will exhibit lowered cognitive ability, a significantly impaired memory, and the inability to make sense of relatively simple concepts. These impairments of the mind can make the patient’s ability to communicate their desires and express physical discomfort. It can be challenging to determine, for instance, if a loved one with dementia is refusing to eat due to their mental confusion or because of the naturally decreased appetite associated with the dying process. Likewise, it can be easy to confuse an expression of physical discomfort with aggression stemming from confusion.

Providing spiritual and emotional comfort for those with dementia can pose a challenging feat. Will a loved one understand how you feel about them? Will family members have their goodbyes understood by a grandparent with advanced Alzheimer’s disease? Will discussing precious memories provide comfort or further confusion and frustration? During these times, when family members and friends don’t know how to give support to a dying loved one with dementia, skilled palliative care and hospice professionals can be an immensely helpful bridge to patient comfort.

Providing Comfort Via Sensory Stimulation

One approach to providing comfort to a loved one with dementia is through more universal comfort zones — primarily soothing sensory inputs. Enjoyable music and sounds associated with nature can have a dramatically positive effect on the mood of these patients. Gentle massaging of the hands and feet can help to relax those experiencing discomfort and confusion. These sensory techniques are some of the most beneficial modes of providing comfort to those with dementia.

Determining Proper Ongoing Care

When nearing the end of life for an Alzheimer’s or Parkinson’s patient, it is crucial to decide which treatment is going to provide the best possible quality of life. Some medications can delay symptoms for a while. Other drugs can limit some unfavorable behavioral problems. While this is the case, some caregivers may not feel comfortable administering medications intended for later-stage Alzheimer’s disease. Other concerns may be whether or not the drugs will, in fact, improve their quality of life or if they come with adverse side effects. When making treatment decisions, the positive and negative outcomes should be weighed to make the best decision possible. Ultimately, a caregiver may need to make the appropriate treatment decisions based on the ongoing condition of the patient — sometimes weighing extending life against increasing the quality of the time they have left.

For help navigating end-of-life care for loved ones with dementia, Cura HPC is here for you. We invite you to learn more about the experienced palliative and hospice care specialists from Cura HPC today.  

When a loved one is going through the dying process, many of us tend to try to supply support in the most significant areas. Oddly enough, the dying may experience more stress about the coordination of everyday activities in their absence. Frequently, this is where you can provide the most assistance. 

Practical Jobs Can Make a Big Impact

As a loved one begins the dying the process, you’d imagine various sources of stress. Putting aside the existential, emotional, interpersonal, and spiritual issues that the dying may experience, managing day-to-day activities may be the source of the most uncertainty. Knowing that everything will be appropriately managed in their absence may be one of the most significant causes of relief that they may experience during the dying process. This is where you, a friend or family member of someone in the dying process, can offer immense support. 

Managing the Handling of Affairs

Among the questions the dying have, some of the most profound are the most basic. “Who is going to water my plants?” “Who is going to take care of my husband?” “Who is going to feed my dog?” “Who will pick up the children from karate?” “Who is going to make dinner for my family?” Though you’re likely not the medical professional making significant decisions about your loved one’s hospice or palliative treatment, where you can have a significant positive impact is by managing the day-to-day tasks that the dying person was once responsible for and where now worry. 

Accept Help Where Offered

If you are the primary caretaker of someone going through the dying process, do not feel the need to take on managing the physical and emotional needs of your loved ones in addition to all of the day-to-day activities. Other family members, friends, and community members will likely lend their services. While you may feel that their help will inconvenience them, realize that by allowing them to shoulder some of the day-to-day responsibilities, you are putting their minds at ease about your present state. Just as you may worry about all of the tasks that need to get done, they too worry about your ability to complete these tasks while also providing the emotional support where it is needed. By letting them help, you’re not only helping yourself, but you’re also helping them. 

Let the Professionals Help

When a loved one is going through the dying process, it’s normal to feel the need to do everything you can to ease their discomfort. While the help of family and friends is encouraged, realize your limitations. Understanding that you will also need help as well through this process. There’s no shame in embracing the help of experienced professionals during this time. 

For help in any matters relating to hospice and palliative care, look no further than Cura HPC. Learn more about Cura HPC today.

The dying process can be difficult and confusing not only for the one dying but for loved ones as well. As a loved one, you may not know what you need to be doing in order to make the dying process physically easier. Let’s take a look at areas of physical discomfort that can be managed during the dying process.

Managing Pain

As the body begins to shut down, some patients experience certain amounts of pain. Though not every death is a painful one, it’s completely normal to relieve pain through the use of prescribed medications. A palliative care specialist will know which medications to prescribe and their dosages. If the medications prescribed are not providing any relief, it is important to let your palliative care specialist know this for they can adjust the medications and/or dosages. 

Respiratory Issues

During the dying process, it’s not usual for a patient to experience shortness of breath. This difficulty breathing is called dyspnea and can sometimes cause anxiety. Some means of remedying this is shortness of breath include elevating the head, opening windows to increase the flow of fresh air, the use of a humidifier or a fan to move still air in the room. Some doctors may administer morphine or medicines that help to limit the feeling of breathlessness. As death nears, breathing may become very loud and labored. Though this can be quite startling to loved ones, it usually does not upset the patient. 

Digestive Issues

Towards the end of life, digestive problems such as nausea, constipation, loss of appetite, or vomiting are common. Though they mostly stem from the natural process of the body shutting down and energy being rerouted to life-sustaining organs in the body, some can be treated. It is important to speak to a nurse or other medical professional about these in order to ease discomfort. While a dying person may require help to eat if they desire to do so, do not have them eat if they do not want to. There is a certain point where eating may cause great discomfort or nausea, so do not be disturbed if the patient gives up food or drink almost completely.

Skin Issues

Skin can become unusually dry on the face, eyes, and lips before death. Lip balm, moist cloths, and alcohol-free lotions can help to soothe the skin. Offering ice chips and wiping the inside of the mouth with a damp cloth can help relieve dryness in the mouth. Sitting in one position for an extended period of time can cause bedsores, so it is important to change positions from time to time. Harder services such as railings can irritate elbows, hands, and feet, making foam padding a source of comfort. 

Though you may feel helpless to prevent the death of a loved one, helping them remain comfortable throughout the dying process can make all the difference — for the dying person and loved ones alike. 

If you’d like to learn more about palliative care and hospice services in Tulsa, OK, you’re invited to learn more about Cura HPC. 

Learn more and connect with Cura HPC Palliative & Hospice Care Services in Tulsa, OK today.

The full scope of care for someone who is dying would be incomplete without caring for one’s emotional needs. Some who are nearing the end of their lives may become confused, anxious, or even depressed. These feelings should never be discounted as side effects of the dying process but should be treated with the same level of diligence as anyone else experiencing such feelings. 

Seeking Assistance

While you as a loved one may be able to provide some relief by your presence and communication with the dying person, there may be times where a professional counselor may be necessary. These specialists can help the dying ease their anxieties and even depression. If the assistance of a mental health professional doesn’t prove to be as effective, certain calming medications can be administered. 

The Need to Remain Present

It can be hard to remain close to someone throughout their dying process. Even if someone is dear to you, it can feel too painful to experience with them. This is not uncommon. Even medical professionals have been known to withdraw from dying patients whom they were unable to completely treat. It’s important to remember just how much of a calming influence you can have during their last days. Rubbing their hands or feet, massaging their shoulders, talking with them about good times, or even just being with them are all immensely helpful. Always talk to them and never about them in their presence. Even if the dying person is unconscious, some medical professionals are of the opinion that there is a likelihood that the person can still hear you.

If you would like to know more about the palliative and hospice care professionals in Tulsa, OK, you’re invited to learn more about and connect with Cura HPC. 

Learn more about and connect with Cura HPC Hospice and Palliative Care today.

Why do the dying lose their appetite? 

The digestive process can be fairly taxing on the body. The process of breaking down foods or even processing nutrients require a level of energy that the dying person may just not have. One way even the healthy may have experienced this is growing nauseous or even vomiting following an intense physical workout. During an exhaustive workout, the body reallocates resources such as blood and energy to the muscle groups and organs that require it most. This leaves the digestive system with limited energy, thus frequently inducing nausea or vomiting because it is unable to process the food at the moment. A dying person’s body is reallocating similarly limited energy supplies to keep the essential systems of the body working. Because of this, their bodies lack the strength to digest food, thus making the presence of that food or fluid in their systems uncomfortable or even intolerable. 

Do people ultimately die of starvation? 

It may seem like a loved one towards the end of life who has not eaten perhaps in days or even over a week is essentially dying of starvation. This is not the case. The person will eventually pass away due to their illness. It is important to remember that it's not they have simply given up on life and chosen not to eat or drink, but they simply can’t and often do not want to. 

Isn’t it painful not to eat or drink while dying? 

Most of us can hardly imagine going more than a day without eating. The dying, however, typically do not experience discomfort associated with not eating or even dehydration besides possibly a dry mouth. Once dehydrated to a certain degree, the brain frequently releases endorphins that block many pain receptors — a kind of built-in pain-killer system. These endorphins can even induce a euphoric feeling. Artificial nutrition, on the other hand, can induce a form of false hope for the body, allowing it to continue to fight to stay alive — a painful, hopeless fight that typically only prolongs the dying process. 

If you would like more information about hospice or palliative care in the Tulsa area, you’re invited to learn more about and reach out to the caring professionals at Cura HPC. 

The purpose of morphine and other painkillers throughout the dying process may seem fairly clear — to relieve pain. While this is true, morphine and other related opiates (such as codeine, hydromorphone, or fentanyl), have another purpose: to decrease the shortness of breath among the dying. Also known as dyspnea, short or labored breathing is a common experience among those in the dying process. While not necessarily painful, symptoms of dyspnea are uncomfortable and can greatly induce feelings of distress or anxiety. As somewhat of a catch 22, the anxiety surrounding dyspnea can exacerbate the symptoms and make breathing even more difficult. In order to provide relief from these symptoms, opiates such as morphine may be used to help alleviate both anxieties as well as the shortness of the breath. 

Can Morphine Speed Up Dying? 

Some families of the dying or even the dying themselves may have some reservations against using morphine and other painkillers to decrease breathlessness. There is an erroneous idea that morphine hastens the dying process. Part of this misconception is from experiences where death was immediately preceded by a dose of morphine. This is an important time to remember that correlation does not imply causation. The doses of morphine given to the dying are of relatively low and do not directly hasten death. Doses are given in relation to the person’s breathing needs and levels of discomfort. The purpose of hospice or palliative care is not to bring about death, but to alleviate as much pain and discomfort as possible from the dying process. For this, morphine is often a useful tool.

If you would like to speak with a hospice or palliative care specialist, the professionals from Tulsa’s Cura HPC are here to help.

Learn more about hospice and palliative care from Cura HPC today. 

Every day, people nearing the end of their lives receive unwanted medical treatment. Whether these are burdensome ICU stays, long-term feeding tubes, artificial ventilation, or even hospitalization at all, many receive the unwanted treatments that only delay the inevitable and making the dying process worse. Maybe they only wanted a treatment that would enable comfortable without extending their life. Maybe these people wanted to be able to pass away naturally at home. Because many cannot voice their preferences, the default action is for first responders and physicians to seek to extend their lives. If only they could easily inform these medical professionals of their treatment preferences...

Enter the POLST form.

“What is a POLST form?”

The acronym P-O-L-S-T stands for Physicians Orders For Life-Sustaining Treatment. This is typically a one-page, front-and-back form with checkmark-boxed questions that individuals use to tell first responders and physicians what kind of life-sustaining treatment they wish to receive in the event that they would require it to remain alive.

“How does a POLST form differ from an Advance Directive?”

The differences between a POLST form and an Advance Directive largely have to do with the logistical challenges posed by the needed speed of required treatment. In many instances, first responders have to quickly assess what kind of treatment someone wants. If the person is incapacitated, first responders and physicians may end up delivering treatment the person does not want. While an Advance Directive does convey what kind of treatment someone does or does not want (for example, ventilation, feeding tubes, or even simple CRP services), finding this information at a moment’s notice in an Advance Directive during an emergency situation can be difficult. Some Advance Directives are many pages long and may be written in complex legalese.

A POLST form, on the other hand, is typically one front-and-back form with around 10 treatment questions that are marked with checkboxes. At a glance, anyone can immediately know what kind of treatment the listed party wants and does not want. Many are instructed to leave it attached to their refrigerator in case first responders need to quickly reference it in an emergency situation. This makes the POLST form somewhat of an outline or “cliff notes” version of an Advance Directive when the information is quickly needed.

How does a POLST form differ from a Do Not Resuscitate (DNR) form?

Like an Advance Directive, a POLST form can work in concert with a DNR order. While a DNR order that can be displayed with a wrist band or other insignia and denotes not wishing to receive a CPR-related treatment, a POLST form provides additional details, such as the duration of life-saving treatment or hospitalization. A POLST is not a substitute for a DNR, but the two can work together to make sure the patient’s wishes are respected.

Who is a POLST intended for?

Unlike an Advance Directive that is a great idea to have no matter your age, a POLST form is especially recommended for people who may be in their last year of life or have any other form of an irreversible life-limiting condition. The POLST form is best suited to keep individuals from receiving unwanted treatments, making it not completely necessary for younger, healthy, able-bodied individuals.

With that being said, because of it’s succinct nature, a POLST form can be used as a tool to help those in the 50s, 60s, and 70s start seriously considering making their end-of-life wishes known to loved ones and physicians.

What if someone changes their POLST preferences?

If someone changes their end-of-life treatment preferences, the POLST form is completely amendable. It can be adjusted at any time. As long as they are able, one can make changes to their POLST form.

What is required for a POLST to be legally binding?

The only requirement for a POLST form to be legally binding is for it to be signed by the patient or a representative and the patient’s legal healthcare representative.

If you would like to download an Oklahoma POLST form, you can do so here . It is requested that it is printed on pink paper so as to increase its visibility.

If you would like a printed copy of the POLST form or would like to speak to someone about end-of-life care, look no further than the friendly people at Cura HPC Hospice & Palliative Care in Tulsa, OK.

Learn more about Cura-HPC Hospice & Palliative Care here.

Mortuary Services Can Be a Huge Expense

Many will end up spending more for funeral expenses for a loved one than they will for a car. Still, how many of us would feel that they were well suited to go car shopping immediately after a close loved one has passed away? Every decision would be filtered through grief and there’s little doubt that one’s judgment could be questioned. In the same way, waiting until the passing of a loved one to shop for final arrangements has a similar effect. People simply aren’t good at making the best money decisions when under major emotional distress.

Shopping After Passing Leaves One Wondering

Keeping in line with the car-buying analogy, how comfortable would you be buying a brand new car for a loved one who had never spoken a word about what they value in a car? You would simply have to think about their personality and essentially make a series of guesses. Do they like a sportier car or a luxury sedan? Would they prefer an environmentally-friendly electric car or would they actually be happier riding a bicycle? Any decision you’d make would still leave you to lie awake in bed at night, wondering if you had made the right the right decision. However, if they simply told you what you’d want, this would immediately streamline the entire process. This is what you can do for those you leave behind.

Your Choice Will Always Be Your Choice

One of the reasons people tend to purchase some of the highest-priced mortuary services and products are to “properly” honor their loved ones. If that loved one could see the itemized receipt for all of these products and services, they may not approve of such expense on their part — especially if the person paying had to go into debt in order to do so. However, one way to guarantee that one would approve of it is for the person to actually approve of it before they pass away — that person is you. When you make your own arrangements, not only are your loved one’s not essentially “car shopping in the dark” for you, but the expenses can even be negotiated. Yes, you can haggle for your own mortuary arrangements without appearing “cheap.” No one can argue with what you want or the budget of your final wishes.

To ensure you or your loved ones ability to pass on in as much comfort, grace, and dignity as possible, the hospice professionals from Cura HPC offer nurturing care. Feel free to reach out to us to discuss what options are available — either for the immediate or distant future.

Ken’s grandfather, Loren, had been diagnosed with Parkinson’s disease many years prior, but his symptoms were becoming much more severe. Without being able to gain relief through the usual treatments, the family was nearly at a loss at what to do. One of the physicians associated with the senior living facility where Loren lived recommended that the family seek specialized palliative care for Loren. Upon hearing this recommendation, the family’s we surprised and their worry intensified. 

“Palliative care? Does that mean that his time with us is shorter than we thought?” 

“No, no,” the physician explained. “You’re probably thinking of hospice care — not palliative care. While Loren’s Parkinson’s is fairly severe, I don’t see him needing hospice care quite yet.” 

Loren’s family was justifiably confused. Due to a lack of clarity, they believed “palliative care” and “hospice care” to be synonyms. This mix-up led to an emotionally confusing situation. 

What is Hospice Care? 

While the definition of “hospice” stems from “hospitality”, the definition of the term in modern times means to care for as well as attempt to limit the suffering of the more immediately terminally ill. Hospice care has a unique protocol that is designed to not only comfort the dying but help families prepare themselves for the process of saying goodbye to a loved one. Hospice care is recommended when the end of life is more clearly in sight for medical professionals so the appropriate care can be provided. 

What is Palliative Care?

Unlike hospice care, palliative care is a special process of easing the symptoms of a disease or injury rather than seeking curative treatments. Many maladies that presently have no cure cause patients immense suffering and attempts to cure them may not be feasible or may even cause additional undue suffering. Some of these long term, yet not necessarily immediately terminal diseases may include certain varieties of kidney disease, liver disease, long-running cancers, AIDS, Parkinson’s Disease, ALS, and many others. While hospice may care may be necessary eventually, the approach of palliative care focuses on making the pain and discomfort more palatable in the meantime.  

In Summary

• While they are sibling methods of care, palliative care, and hospice care are not the same thing. 
• Hospice care is specialized to provide comfort to more immediately terminal patients and their families as the patient approaches their last days. 
• Palliative care is specialized to alleviate as much of the discomfort of an ongoing ailment as possible when a cure is less likely. 

If you or a loved one are currently being recommended palliative care or hospice care, we invite you to learn more about the professional and nurturing Tulsa area hospice and palliative care services of Cura HPC. At Cura HPC, we care for your family the way we’d care for our own.

Learn more about Cura HPC. 

Visiting loved ones that are living with an incurable disease can be hard — knowing what to say, what to do or how to act may be difficult. But time is of the essence. Here is a short list of activities that can help you engage with loved ones who are in hospice care.

1. Remember the good times.

Now is a great time to bring up fond memories and “remember when” stories. This often will lift the spirits of the patient and also provide a much-needed distraction. A few laughs may be just what the doctor ordered. Feel free to bring pictures, videos, or music that you know will bring them joy. Positive reminiscing can help the patient recall the great times they had — moments of warmth, of joy, and pleasure. This form of nostalgia can greatly impact a loved one.

2. Talk, but on their terms.

While talking with a loved one in hospice care is very therapeutic for the patient and visitor alike, be sensitive to their willingness to speak. If they don’t want to speak, don’t press it. If they can only answer in “yes” or “no” gestures, only talk in ways where those are the only necessary answers. Keep your talking to subjects that you know they like and remain positive. Never squabble or speak ill of others while in their presence.

3. Read to them.

Reading to loved ones in hospice care — whether fictional stories or on a subject you know they enjoy — is a great way to spend time with them. Bring a variety of works you think they may enjoy and let them choose which selections you will read. Get their feedback on the content of what you’re reading as you go in order to include them. They should always feel like you are reading to them and not at them.

4. Touch and interact with them.

With proper permission, don’t feel worried about touching them. Brushing hair, giving hand or foot massages, or just holding their hand can help make them feel special. Interact with love and respect. Touch not only helps them bond with you but also helps them to feel loved.

5. Just be with them.

Sometimes, nothing needs to be said. Letting the patient guide the conversation can sometimes result in complete silence...and that’s ok. The silence may feel uncomfortable, but let it serve its purpose — just time spent in their presence. Looking into the face and the eyes of a loved one can provide immense comfort to the patient and visitor alike.

6. Say goodbye to them.

The patient likely knows that they are dying, so it is typically ok for you to say goodbye. It may be hard to do and some tears will more than likely flow, but this is quite healthy. Offer hugs and tell the person how they have impacted your life. Tell them, lovingly, how much you will miss them and that you will never forget them. This feeling of being remembered can feel like a victory over dying for many hospice patients.

Cura-HPC | Your source for compassionate care.

If you or a loved one require hospice care services, the friendly professionals at Cura-HPC can definitely help. Our experienced and nurturing medical professionals provide specialized care that is sensitive to the unique needs of patients and their loved ones.

Approaching the need for hospice services can be challenging. You may have some questions.

“How do hospice services differ from other health care services?”

“To what extent will my loved one’s unique needs be met by hospice staff?”

Hospice Care Nurses and Other Personnel

Just as a specialist is best able to treat unique medical needs, the hospice team is dedicated to addressing the unique needs of those requiring end of life care. One of the most vital aspects of this specialized care is the role of the hospice interdisciplinary team. The Cura hospice team is comprised of hospice and palliative care certified medical professionals with specific training and experience who specialize in meeting the distinct medical and emotional needs of patients approaching the end of life. Cura-HPC physicians, nurses, social workers, and chaplains provide education regarding the disease process and provide expertise to manage symptoms and control pain — which is often associated with end-of-life disease.

“How will hospice help me as a caregiver?”

Taking care of anyone, in any stage of health, can be a challenging full-time job. In some instances, a caregiver can feel uncertain about caring for the new and emerging needs of their loved one. The role of the hospice nurse is to provide education and support to caregivers and family members during this challenging time. The gradual passing of a loved one can leave loved ones physically and emotionally drained. The entire Cura hospice team, including social workers, aides and chaplains will be available to provide psychosocial and spiritual support so that families can engage and embrace this journey with their loved one.

You probably have a variety of very unique questions about the specifics of hospice care. In order to have your questions answered and your anxieties relieved, we welcome you to reach out to Cura-HPC. To set up an appointment to speak with a hospice professional, feel free to call 1-800-797-3839.

It can be quite difficult to experience a loved one who is suffering from early or advanced stage dementia or Alzheimer's Disease. Visiting a friend or family member who is experiencing lapses in memory or changes in behavior due can be challenging, but it is quite meaningful for all involved — the patient and visitor alike. In this piece, we’re going to examine some of the things you’ll want to not do and do when visiting someone suffering from Alzheimer’s Disease or dementia.

Don’t:

• bring up the idea of memory. Asking someone with dementia to recall anything is not polite and may cause immense frustration.
• use any critical terms. Pointing out failing, mistakes or messes may aggravate someone with cognitive difficulties.
• talk around them. Always include the patient in any conversation happening in their presence. Speaking as though they can’t hear or understand you is inconsiderate.
• correct them on inconsequential points. Arguing with someone who is irrational can cause intense frustration for the patient and visitor alike.
• ask them sensitive questions. Keep all questions simple and inconsequential, giving them plenty of time to answer.

Do:

• schedule visitations appropriately. The idea of “the more, the merrier” does not apply. Too many people can be overwhelming for dementia patients. Keep visitation to one or two people at a time.
• remove distractions. Televisions, radios, phones and other noise-creating devices should be turned off and stowed away if possible.
• prepare other visitors. Just as you’re preparing now, make sure that other visitors are sensitive to the needs of the patient. Make sure all preparations are done before arriving for visitation.
• remain positive. Keep all of your bodily movements intentional and somewhat slower so as not to startle the individual.
• identify yourself. Even if this is a parent, grandparent, or close friend, make sure to introduce yourself. State your name and your relationship with them. “My name is Marco. I am your nephew.”
• talk in short, simple sentences. Trying to comprehend longer sentences may be difficult for those with dementia. Keep statements and questions very short and to the point.
• follow their pace. Guage their mood and level of energy. Never urge them to do something they don’t want to do.
• give the person affection. If the patient is comfortable with a hug, feel free to give them one. Always ask first and tell them that you are going to hug them so there are no surprises.

At times, you may wonder if the person you’re visiting even realizes that it is you whom they are visiting. Regardless of this, visitations can help those suffering from Alzheimer’s or dementia on many different levels.  

There are few words that can express the feeling of being told that you or a loved one may need to begin planning for end-of-life care. Many emotions can well up inside — confusion, defeat, anger, and depression are just a few. While we realize that no one escapes the natural rhythm of time, we all pray for a quick, unexpected, yet peaceful passing. This isn’t the case for the majority of us. Because we and so many of our family members will face our passing long before it is immediately upon us, it’s important to open lines of communication with hospice services to determine which best meets your needs — even before their services are immediately necessary.

Talking Logistics is Not Giving Up On Hope

Speaking to car insurance agents about policies doesn’t make us apprehensive about riding in automobiles. Buying fire damage insurance doesn’t make us increasingly wary of lighting candles around the house. Why then would making arrangements for hospice care make us feel that we’re inviting death into our homes? Part of the reason for this is because, while there is a possibility of going through life without a single car accident or house fire, you will eventually pass away. Speaking to hospice care representatives, especially as your health or the health of a loved one deteriorates, can feel like giving up on life. This is probably the single biggest myth about hospice care. Talking to hospice is not waving a white flag, but instead planning for that which no one can avoid.

The Comfort of Knowing

Many have reported scenes where they were given the hardest pill to swallow — that it would be a good idea to start making arrangements for end-of-life care, but that they felt immediate relief from many of their anxieties upon meeting with hospice care representatives. If this is your situation, do not despair. Do you know who also needs to make arrangements for end-of-life care? Absolutely everyone. There is not a soul alive who shouldn’t be making the right arrangements for their care towards the end of life. On the other side of this coin, those who pulled the trigger on speaking with hospice care representatives actually felt much more at ease about their fate or the fate of their loved ones. The comfort of knowing that they or their loved ones would be receiving the utmost quality care was one less thing to worry about. This comfort can be yours as well.

It can be uncomfortable to even think about worse-case scenarios, let alone talk about them with those closest to you. As uncomfortable as we may feel, life’s ups and downs will occur regardless of our feelings. In order to make sure that your wishes are being met, regardless of your ability to communicate, a legal Advance Directive is the best route — and not just for end-stage patients.

What is an Advance Directive?

Most of us are familiar with a will — a legal document declaring what will be done with your earthly possessions in the event of your demise. In that similar vein, an Advance Directive is a legal document that spells out what kind of medical treatment you’d prefer to receive or not receive in the event that you are incapacitated and physically unable to make such requests.

Power of Attorney vs Advance Directive

One way we like to deflect planning for the worst is by placing this responsibility on whoever has our Power of Attorney. Someone you have given Power of Attorney is typically someone close to you whom you’ve selected to make major legal decisions on your behalf. While issuing someone to be your Power of Attorney is helpful in many situations, there can be complications with placing all of the decisions on their shoulders in the event of an unfortunate event. While you may be in a lucid and calm state right now, in the event that you unable to physically communicate, your Power of Attorney may make hasty or irrational decisions using their emotions in place of what you would have wanted. Another downside to placing that level of responsibility on your Power of Attorney also means you’re saddling them with the grief and doubt of trying to determine what care you would have wanted. Wondering if they made the right decision may be an immense burden that they carry the rest of their lives.

Advance Directives For Everyone

Most able-bodied individuals do not have an Advance Directive. A lack of an Advance Directive can be a major issue in the unfortunate event that they are incapacitated and important legal and medical decisions need to be made. Even if someone has Power of Attorney to make the necessary decisions, their choices, no matter how well-intentioned, can cause strife within friends and family members who do not agree with their decisions. If someone has an Advance Directive, there’s no one to be upset with because the subject’s wishes are the ones being carried out. Because unfortunate incidents happen every day ranging from car wrecks to brain aneurysms to getting hit with NASA space debris, planning for what kind of treatment to receive or not receive can help lift the burden of the mystery of knowing what kind of treatment you would have wanted.

Each state’s laws for Advance Directives differ, but here is a copy of a blank Oklahoma Advance Directive.

“‘Everybody knows they’re going to die, but nobody believes it. If we did, we would do things differently,’ Morrie said. ‘So we kid ourselves about death,’ I (Mitch) said. ‘Yes, but there’s a better approach. To know you’re going to die and be prepared for it at any time. That’s better. That way you can actually be more involved in your life while you’re living. . . Every day, have a little bird on your shoulder that asks, ‘Is today the day? Am I ready? Am I doing all I need to do? Am I being the person I want to be?... The truth is, Mitch, once you learn how to die, you learn how to live… Most of us walk around as if we’re sleepwalking. We really don’t experience the world fully because we’re half asleep, doing things we automatically think we have to do… Learn how to die, and you learn how to live.’”—Tuesdays with Morrie

It’s hard to say what can be considered more worrisome, death or dying. For many questioned, the greatest source of despair was not their impending demise, but instead, regret —  that they had not yet accomplished what they wanted to do, usually because of some fault of their own.

According to one Quora user in a forum on the subject, their patient had this to say about the sensation: “It is a bittersweet thing to know you are going to die soon. Bitter, because of everything that you wanted to do, but for one reason or another, you didn't. Bitter because there are burned bridges that can never be rebuilt. Sweet because you know the pain is going to end. The daily suffering is almost over. The emotional turmoil is getting close to being done. Sweet because the people that you were arguing with, you make up with. Sweet because whatever afterlife you believe in, or don't believe in, you know and can't wait to get there.”

Being given notice that your departure from this world will be sooner than you thought can bring a whole new perspective, as the legendary Morrie stated above. Not only does hospice care provide the physical support needed by those nearing the end of their lives, but the emotional support of those navigating the inner process of those who can see the finish line.

Most people don’t want to talk about hospice. For many, hearing the word “hospice” is equated with death — a concept that gives many the willies. Even though there shouldn’t be anything inherently disconcerting about death as it’s something we will all eventually experience, the fear and discomfort with the topic endures. While this is the case, fear and anxiety should not be correlated with hospice care.

While the death of patients is something that typically occurs in the process, hospice care is about making the most of the quality of the rest of our lives. If you one were to remove the cultural stigma and connotation of hospice as “the caretakers of the dying” and instead thought of it as “the comfort enhancers of the those very much alive,” who wouldn’t want hospice care at any stage of life? Hospice specialists are caretakers of the dying, yes, but they are not caretakers of the dead. Hospice workers are not angels of death. Instead, every hospice professional is dedicated to improving the quality of life for all of their patients much in the same way we care for the vulnerable of whom we cherish — no matter how far from death they appear.

In order to ensure the highest quality of care for our loved ones, it is high time we squashed the misconception that hospice is about death. Death is not the focus of hospice specialists, but instead the comfort and joy of the living. Hospice is not about defeat, but rather about relief from the struggle. Hospice is not about counting down to the moment of one’s demise but rather embracing the new chapter of living — which many have said is one of the most vibrant stages of their lives. Hospice care is not about sympathetic coddling, but rather about helping to navigate the feelings of experiences yet to be had. Hospice is not about death, but rather about enhanced living.

Whether you’re a palliative care professional or close family member to someone who is nearing the end of their life, knowing what to say to someone who is dying can feel like a delicate and confusing tightrope walk. While our natural instinct is to soften the tone of our language to cushion them through the process, the opposite fear is being disingenuous with our words and ignoring the elephant in the room. In this piece, we’re going to explore how to speak to someone who is dying in a way that is supportive as well as sincere.

Remember That This Isn’t About You

When speaking with a person who is dying, we have the tendency to let our own thoughts and feelings guide our speech and even to make us feel the need to speak at all. In many instances, letting the individual guide the conversation is the key to the most supportive conversation you can have. If they want to know how you are feeling, they will typically ask, but remember that just because they don’t ask doesn’t mean they don’t care. This situation isn’t about you so it’s best to be a helpful passenger in the conversation rather than a backseat driver.

Never Speak To Someone Or About Someone As Though They’re Already Gone

Unless you work in hospice care or in some avenue of palliative care, we typically don’t interact with dying people that much. This lack of experience can make us emotionally combine the process of dying with the process of grieving a death. While grieving may begin even upon discovering that someone is dying, the language associated with grieving their death has a time and a place — after they’ve passed away. Offering sympathies to the families of someone who is dying or even carrying such a tone when speaking to dying is generally not helpful, if not insensitive to their current needs. While there is still time that can be spent with the person, it should be spent helping them in whatever capacity they need — physically, emotionally, or spiritually.

Feel Free To Dive Into Positive Memories

Our memories are our most prized possessions. When speaking with someone who is dying, if the conversation is flowing, feel free to ask them questions about some of their favorite memories. Ask them about their favorite people and the specific moments they have spent with them. Ask them if they have any particularly funny stories about these people. Ask them what details they love the most about their loved ones. Their answers can be tremendous mood lifters and distractions from hardships. This line of conversation comes with a disclaimer: Though memories can be great conversation starters, it is typically recommended to avoid asking them to recall specific memories that can either end up being painful or if illness or old age have made recalling memories difficult and therefore frustrating.

Don’t Offer Any False Assurances

Coming to terms with the idea of dying is a process unto itself, which makes the act of making false promises or assurances a step backward in the process for the dying. Though our gut reaction tells us that some words of hope may brighten a dying person’s day, the truth is that these false assurances only damage our trust with the individual. They know they are dying and they typically don’t appreciate being lied to. Be willing to talk about the elephant in room if they want to, but don’t make it any heavier with false hopes.

Don’t Be Afraid To Make Peace & Offer Thanks

Though we should make sure to remember that their dying process is not about us, if something we need to say will bring comfort to the dying, it is ok for it to be said. One area that feels negative but can ultimately be positive is asking for the forgiveness of a dying person for any wrong you’ve committed against them or hardship you’ve caused. While it may feel that asking of forgiveness may set a negative tone, asking for forgiveness frequently brings about feelings of reconciliation — a positive occurrence. And even though it may sting of finality, it is ok to thank the dying individual for the positive impact they’ve had on your life. Mentioning specific acts of kindness or ways they have helped you may be a great way to share some positive memories. Hearing specific details about your gratitude may leave the dying feeling better about the positive impact they’ve had on the world as well as the joyous moments you’ve shared.

Sometimes, There’s No Need To Speak

Nobody likes an awkward silence, but an awkward rambling of unguided, unproductive speech can be as equally uncomfortable. In many instances, a dying person, as well as grieving person, doesn’t need you to speak — they just need you to be there. A great approach can be to let the dying or grieving person initiate and steer the conversation. Lend your thoughts to keep the conversation going so they don’t feel like they’re speaking to a wall. In all things, be a helpful passenger on their journey.

As a perfectly healthy individual, unless you work in the healthcare industry, you probably don't talk about death that much. While talking about your own death while you’re still healthy can erroneously lead friends and family members to wonder if you know something that they don’t, talking about your own death is not only healthy but will also be appreciated by those you leave behind. But why? In this piece, we’re going to look at a few reasons why it’s beneficial to plan for your own death while you’re perfectly healthy.

1. You’re in control.

Probably the most obvious reason to plan for your own death is in to ensure that your final wishes are known. Because even the idea of death makes many people feel uncomfortable, many die before talking about it. Those who have died without having discussed their final wishes with family and friends then put those loved ones in the unfortunate scenario of guessing what final wishes would have been. Without your plans or your permission, your loved ones will simply have to wonder what you would have wanted. Not only will this lack of planning leave them forever wondering what you would have wanted and if they made the right decision, but it also makes them vulnerable to reason #2.

2. You’ll potentially save yourself and loved ones a lot of money.

When you haven’t made it clear how you would like to be laid to rest, those in charge of arranging your burial may feel the need to give you a grand send off...which may be more expensive than you would have wanted. Naturally, your loved ones won’t want to potentially “cheap out” on your final wishes, leading them to be vulnerable to funeral home up-sales. When you plan for your own death while you’re alive and still healthy, this allows you to price shop for the best deals with the freedom to be as thrifty as you want to be. Shopping for caskets, burial plots and even planning your funeral while death is not imminent is also the best time to do so because of what is included in #3.

3. You’re the most physically capable of planning for your death now.

There are those who remain completely lucid and functional until the very end. For most of us, declining health will make the task of planning for death that much more arduous. When you plan for your own death while you’re in peak health, you’re most likely to consider every detail, go after every savings, and take this burden off of your loved ones — a factor to take into consideration in #4.

4. Your loved ones will not want to.

Would your loved ones make your final arrangements if you hadn’t already? Absolutely. Do they want to have to do this? Absolutely not. Planning for the death of a loved one usually means that the individual being planned for is incapable of doing the planning for themselves — meaning that they’re usually in the process of dying or have already died. While you’re in this state, your loved ones will be absolutely beside themselves. Losing a loved one can be a severely traumatizing event that is made worse by then having to make a series of extremely significant and expensive decisions. One of the most generous things you can do for your loved ones is to plan for your own death as extensively as you can. In doing this, you’re basically removing the stinging burden of having to make every decision for you.

In future articles, we will discuss what aspects of your death you should consider when planning for your own demise.

Choosing who will care for your loved one during their final days isn’t a decision to be taken lightly. As most people aren’t familiar with the interworkings of the hospice industry, it’s common for families to experience some difficulties when comparing one hospice to another.

To make the best decision for your loved one and the rest of your family, consider these four factors when choosing a hospice provider.

Testimonials

Check for online reviews and testimonials. Finding out what people who have actually used a company’s services before think of the company can be a great starting point. Keep in mind that disgruntled customers often take to online reviews to vent frustrations, so be sure this is just one piece of the puzzle and not the evaluation method you use.

Mission Statement

Being a hospice provider is about more than just offering medical care. Emotional support and compassion should make up a large part of how a hospice provider operates. Examining a company’s mission statement and values will help you determine how much they value this side of the business.

Certifications

There’s a long list of certifications hospices and hospice employees can get. Some are more important than others, but the certifications a hospice holds will give you a good indication of what areas of service they prioritize.

Your Gut

Once you’ve narrowed your decision down to a couple of options, set some phone calls and in person meetings. You’ll likely end up meeting with a transition specialist or a social worker. If you get a bad feeling about a hospice provider during these meetings, it might be best to look elsewhere.

At Cura-HPC we work hard to provide the best possible care for our patients and their families. That means having a top quality medical staff and offering caring emotional support. If you are in need of a Tulsa hospice provider, please call Cura-HPC.

There’s a surprising amount of myths and misunderstandings surrounding hospice and palliative care. These misunderstandings will often delay families from enrolling in hospice or keep them from enrolling in hospice care altogether. A simple look at the facts will help those interested in hospice care understand the benefits of hospice and avoid these misunderstandings.

Here are some of the most common hospice misunderstandings and why they’re wrong.

Hospice is expensive

Quite the opposite actually. Medicare, Medicaid, and the majority of private health insurance companies all cover hospice care. This means patients and their families will rarely have to pay anything out of pocket for the care they receive while enrolled in hospice.

You can only have 6 months of hospice

This stems from the fact that patients must be certified as being terminally ill by a physician and have a prognosis of 6 months or less if the disease runs its normal course. This requirement does not mean patients can only receive a maximum of 6 months of care, because the physician’s prognosis may change over time. There is no limit to how much hospice care a patient can receive as long as they continue to get a 6 month prognosis from a doctor.

Hospice only happens in one place

While some patients may choose to receive hospice care by moving into a hospice facility owned and operated by the provider, hospice care can be administered in a wide variety of locations. A patient may receive care in their own home, a skilled nursing facility, a hospital, or almost any safe environment.

As you can see, the benefits are clear when hospice misunderstandings are corrected. If you or a loved one are in need of hospice care, call Cura-HPC for information about our hospice care services. 

When families enroll their loved one in hospice both the patient and the family get access to a wide range of hospice services. One of those services is respite care, which is temporary care provided for the patient at a hospital, nursing home, or inpatient facility so the family or friends who are acting as the patient’s primary caregivers can rest and take some time off.

Being a hospice caregiver can be incredibly draining, both physically and emotionally. As many hospice patients need constant care and attention, it can be difficult for caregivers to take care of themselves. The time off can allow families and friends a chance to recharge their batteries and take care of personal issues they may have been putting off due to lack of time and energy. Doing so lets the caregivers come back focused and ready to take care of their loved one.

In certain cases, family and friends may be temporarily unable to care for the patient due to extenuating circumstances. This can include illness, natural disaster or extreme weather, family emergencies, or other uncontrollable events. During these times caregivers can rest easy knowing someone will be there to care for their loved one.

Getting a break from the duties of caregiving offers physical and mental benefits.

• Knowing their loved one is being cared for by a trained professional, caregivers can finally catch up on some of the sleep they’ve been missing out on.
• Getting to step away from the day to day grind of caregiving will refresh a caregiver’s attitude and renew their energy.
• Just by taking a few days off, caregivers have reported a major decrease in the amount of stress they feel.
• Having some much-needed me-time will allow caregivers to return to their normal diet, exercise, and daily routine.

Respite care is a vital part of hospice care, for both the patient and the caregiver. If you are looking for a Tulsa hospice for your loved one, call Cura-HPC. 

There’s no right or wrong way to grieve, and everyone will experience grief differently. Often, we feel like the grief will never end or like there’s something we could be doing to make it better. While there certainly are steps you can take to improve the grief process, like bereavement care, the way to get over grief is to get through grief. It sounds cliché’, but it’s true. There are so many factors that can affect how a person will grieve that it’s foolish to think there’s a standardized or ideal way to grieve.

That being said, knowing what to expect when grieving a loved one can be helpful. This will help you understand your emotions and feel more comfortable expressing them. Below are a few commonly felt emotions people going through grief may experience. Again, just because you don’t experience any of these emotions or experience emotions not listed doesn’t mean you’re doing it wrong.

Emotions you might feel:

• Shock
• Sudden sadness or hopelessness
• Anxiety about life without your loved one
• Guilt or anger about things that were said and done, or things that weren’t said and done
• Relief that their suffering is finally over
• Not accepting their death

Other, sometimes physical, symptoms of grief:

• A heavy chest
• No appetite
• Mood swings
• A tight throat
• Frequent forgetfulness
• Extreme fatigue
• Not being able to sleep
• Difficulty focusing

It's also not uncommon to act out of character in the following ways:

• Unexpected crying
• Strange cravings
• Undereating or overeating
• Purposeless wandering
• Taking on behaviors and characteristics of your loved one
• Fits of anger
• Frequently talking about your loved one

One of the most difficult parts of caring for an aging loved one is the frequent trips to the hospital. These trips are emotionally draining and they can be expensive. Thankfully, hospice care has proven to be an effective way to reduce trips to the hospital. A study by the Journal of Post-Acute and Long-Term Care Medicine (JAMDA) found that while 44% of nursing home residents are likely to be hospitalized in the final 30 days of their life, that number drops to 22% for nursing home residents who are enrolled in hospice care. As a Tulsa hospice care provider, we are passionate about reducing hospitalizations for our patients an improving their quality of life.

This study involved 505,851 non-hospice residents and 241,790 hospice-enrolled residents living in more than 14,000 facilities across the nation. Of the residents studied, 37.63% of non-hospice and 23.18% of hospice residents were hospitalized in the last 30 days of their life. This means that for every 10% increase in hospice penetration there is a reduction in hospitalization risk of 5.1% for non-hospice residents and 4.8% for hospice-enrolled residents.

After the study was completed, the researchers found that higher facility-level hospice penetration decreases hospitalization risk for both non-hospice and hospice-enrolled residents. Their findings also dealt with nursing home end-of-life care delivery, collaboration among providers, and cost-benefit analysis of hospice care.

Studies like this continue to show the many benefits of hospice care. However, the sad reality is that the majority of hospice-eligible patients will never receive one day of hospice care. At Cura-HPC, we work hard to ensure as many patients as possible receive the Tulsa hospice care they deserve. 

Making the switch to hospice care is almost always a hectic time, especially if it’s a family’s first time to enroll a loved one in hospice. As hospice care functions somewhat differently than standard medical care, families often have several questions. Below is a basic guide to the ins and outs of hospice care.

Hospice Eligibility

It’s important to understand the qualifications for hospice care. The most important factor in hospice qualification is that a doctor determines the patient has a terminal illness, which is defined as having a prognosis of 6 months or less if the disease or illness runs its normal course. There are no exclusions for the kind of terminal illness a patient has. Any terminal illness can qualify a patient for hospice care.

Hospice Team

Once the patient is deemed eligible, a hospice team will meet with the patient and their family to create a customized care plan. The patient’s regular doctor can be part of this team if the patient chooses.

The Goal of Hospice

The care plan will be designed to make the patient as comfortable as possible, not to cure the illness. This style of medical care is referred to as palliative care. Palliative care seeks to improve the quality of life for patients and their families through the prevention and relief of suffering. This goal is accomplished by the treatment of pain and other physical, psychosocial and spiritual issues.

Where Hospice Care is Available

Hospice care can be administered in almost any setting. This includes the patient’s home, hospitals, skilled nursing facilities, inpatient facilities, and anywhere else the patient is comfortable.

The Cost of Hospice

In most cases, families will pay little to nothing for hospice care. Medicare will likely cover everything needed to treat the terminal illness, including both clinical services (like pain relief) and support services. Some services may also be available to caregivers and loved ones at no additional cost.

If you have more questions about hospice care, please call Cura-HPC. We are happy to answer any questions you may have and help you make this difficult transition. 

As our loved ones age, it’s important that we are able to recognize and deal with common health risks that come with aging. Heart attacks are one of those conditions family members need to be able to catch quickly to seek medical attention immediately. Below are the four signs of a heart attack according to the American Heart Association.

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• Other signs may include breaking out in a cold sweat, nausea or lightheadedness.

These symptoms may manifest differently in men and women, but it’s important that families act fast if they think their loved one is experiencing a heart attack. In the event of a heart attack, call 911 as fast as possible. Every second counts when a heart attack is happening.

For more information about heart attacks and what you can do when one strikes, go to the American Heart Association’s heart attack resource center. There you can learn about the signs of an attack, risk factors, and even what to do after an attack happens.

Keeping our elderly loved ones safe is everyone’s responsibility. Sharing this information with other family members at the next family gathering may be an uncomfortable conversation, but it might just save a life. 

According to the Center for Disease Control and Prevention, 1 in three seniors will experience a fall in any given year. What’s even more alarming is that less than half will tell their doctor about the fall. When you consider that falls are the leading cause of injuries to seniors, this is an issue families need to take seriously. Falls can result in a wide range of injuries including: cuts, hip fractures, head injuries, and even fatalities. However, there are practical steps families can take to protect their elderly loved ones.

Clean Up- A clean home is a safe home. Make sure the home is easy to navigate by getting rid of all the clutter that may have accumulated. Keeping hallways and heavy traffic areas of the home free of obstacles is an easy way to promote safety. This should also include repairing falling hazards like loose rugs and wayward floorboards.

Install Handrails- Giving seniors an extra point of contact can shore up balance deficiencies. Put in handrails in areas like hallways, showers, around the toilet, and other accident-prone areas to give seniors one more way to stay safe.

Light it Up- One often overlooked fall instigator is poor lighting. When hallways and stairwells are poorly lit, it can be hard to know where to step and identify hazards. Motion-activated night lights are also a great idea to create a safe environment at any time of the day.

Proper Footwear- A good pair of shoes with a non-slip sole is the ideal kind of footwear. However, some seniors prefer to just wear socks. If this is the case, opting for socks with grips on the bottoms can be a nice compromise. However, shoes are still the best option.

Non-Slip Mats- Floor surfaces that will frequently have water on them should have non-slip mats. This includes showers, tubs, bathroom floors, and kitchen floors. Doing so will give seniors a safe point of contact when conditions are slippery.

Maintaining an active lifestyle is great for the heart, blood pressure, and the waist, but it’s also good for the brain, especially as we get older. By studying brain scans of older adults, researchers have learned that areas of the brain related to memory and decision making perform better among those adults who stay active. The active seniors in the studies tended to think faster and have a better memory.

By keeping active, seniors can improve their odds of avoiding memory loss and dementia. This benefit even rings true for seniors who are frail and limited in motion. The studies showed that even these adults can benefit from physical activity that is appropriate and safe for their condition.

When seniors make the decision to get active, it’s best to start slow and work up to longer or more difficult activities. A good goal would be 30 minutes of activity 5 times a week, but it’s okay if it takes some time to get there.

There are plenty of options older adults can choose from to stay active, and it’s important to pick something they really enjoy. A walk in the park, aquatic activities, or even dancing can all be counted as physical activity.

Adults who are frail or starting to experience limited range of motion should check with their doctors before they decide on a physical activity. They will likely require the presence of an able-bodied adult for safety reasons.

Keeping active is just one way seniors can improve their mental health. At Cura-HPC we want to help seniors stay mentally sharp and improve the quality of life for anyone in need of Tulsa hospice care. If you have a loved who needs hospice and palliative care, call Cura-HPC. 

As the primary caregiver for a loved one, families will spend the most time with a patient, which means they have the best opportunity to spot changes in a hospice patient. Catching these changes early can help doctors make better decisions and improve the quality of the care provided. Here are two kinds of changes families should be looking for.  

Physical

Changes in a patient’s physical condition almost always warrants a conversation with someone on the hospice medical team. Common physical changes include:

• Increased Number of Falls
• Pain when moving or lying down
• Refusal or sudden inability to turn or move
• Skin changes such as sores, tears, bruises, rashes, itching, or a change in color
• Bladder or bowel functions
• Eating or drinking habits
• Shortness of breath
• Loss of sight or hearing

Mental

Changes in patient’s mental state can be just as important to note as physical changes, but they aren’t as easy to spot. Families need to be vigilant and watch out for:

• Increased sleeping during the day
• Difficult to wake from sleep
• Confusion about time, place, or people
• Restless (picking or pulling at the bed linen)
• Talking about things unconnected to the events or people present
• Increased anxiety, fear, or loneliness at night
• Suicidal thoughts or depression

A patient receiving end-of-life care via hospice and palliative care will likely go through lots of mental and physical changes, which makes it hard to know which changes need to be brought up with the nurses and doctors. When in doubt, it’s always best to let the hospice medical team know about changes. Having more information will only help them create a care plan that’s right for a patient’s unique needs.  

Palliative care is a unique form of care that is vastly different than other forms of medical care. The unique nature of palliative care makes it ideal for meeting the needs of patients, under the correct circumstances. It’s important to understand the basic definition, goals, and applications of palliative care.

Definition

Palliative care is a specialized form of medical care for patients with terminal illnesses. This type of care is focused on providing relief from the symptoms and stress of a terminal illness. It is suitable at any age and for any kind of terminal illness, and it can be provided along with curative treatment.

Goal

The goal is to improve quality of life for both the patient and the family. Palliative care teams focus on treating people suffering from the symptoms and stress of terminal illnesses. This type of care treats pain, depression, shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping, anxiety, and any other symptoms that may be causing discomfort.

Administration

A pure form (meaning only palliative with no curative) of palliative care is most commonly found in a hospice setting. However, palliative care methods are also used in conjunction with curative care as well. Palliative care is provided by a specially-trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support.

If you or a loved one is in need of palliative and hospice care, call Cura-HPC. Our experienced team will provide the highest level of care and compassion to all patients under our care. We are able to provide the full range of hospice services including pain management, personal assistance, spiritual care, coordination of care, and bereavement care. 

Rarely, if ever, will a patient be enrolled in hospice care who isn’t currently on some regimen of prescription medications. To ensure a smooth transition and a high level of care for the patient, one of the first steps a hospice medical team will take is a prescription medication review.

As patients move closer to the end of their life, they are often shuffled from specialist to specialist and this can cause issues with medications. According to the American Academy of Family Physicians, one in six older adults who are admitted to the hospital is because of an adverse drug event. This number increases to one in three for patients over the age of 75.

Performing a medication review ensures no medication errors slip through the cracks and helps the hospice provider fully understand the condition of the patient. Once the review is complete, the hospice provider can make any adjustments needed to make the patient comfortable.

One reason that prevents families from enrolling in hospice care is the fear that the patient will no longer be allowed to take the medications they have been prescribed. While a hospice provider may stop some prescription medication that is designed to offer long term health benefits, there are no rules against maintaining prescription medications that provide comfort to the patient.

The medications that are and are not prescribed to a patient will have a big impact on the quality of hospice care a patient receives. That’s why we take this aspect of palliative care so seriously. Our staff is passionate about finding the right medication regimen for each patient to ensure they are as comfortable as possible. 

When a loved one passes away families are confronted with a wave of emotions to deal with as well as a mountain of logistics that need to be addressed. One logistical issue that frequently comes up is transferring the body across state lines. As fewer and fewer families all live in the same town or state, this issue is becoming more common. While this might seem like an overwhelming task, it only takes two phone calls.

The First Call

Once the family decides where they want to bury their loved one, they should call the receiving funeral home. This will start the process of the local funeral home and the receiving home coordinating with each other. After the family signs a few documents, the two funeral homes will decide on the transportation method based on the distance between the two.

The Second Call

The next step for the family to take is getting a burial transit permit. This document contains the cause of death, the deceased’s personal information, the family’s contact information, and the release documentation needed to transport the body. Rules and regulations for these permits change slightly from state to state, so it’s important for families to check with both funeral homes to make sure everything is filed correctly.

The DIY Option

Families can transport the body using their own vehicles, but there are laws that must be followed to do this. A proper shipping container must be used and it needs to be sealed appropriately. There are also laws regarding embalming the body.

Ashes

Regardless of paying a funeral home to transport the body or doing it yourself, transporting a body across state lines can be expensive. The average cost clocks in around $5,000. If this cost is too expensive, a much more affordable option is cremation. Ashes can be transported without the need for permits, making it much more affordable. 

The mind and body can go through a lot of changes and challenges when a person is approaching the end of their life. These changes can manifest in a lot of ways, one of which is called terminal restlessness. As a Tulsa palliative care provider, we’re quite accustomed to dealing with this condition and helping families manage the symptoms. Terminal restlessness can include confusion, anxiousness, and angry outbursts.  

This is more than a simple mood swing or temporary bout of bewilderment; some suffering from terminal restlessness can seem like a different person entirely. Hospice patients with terminal restlessness may lash out at family members with irate claims and demand to see the doctor or speak to the authorities. In some cases, hallucinations have even been reported.

Treatments

The first step in treating terminal restlessness is identifying the root cause of the illness. Terminal restlessness can stem from multiple places, such as:

• Increased levels of calcium
• Fever
• Infections or sepsis
• Medication
• Pain
• Constipation
• Emotional unrest
• Swelling of the brain
• Vital organs shutting down

While some of these causes can be treated, others are unfortunately just a part of the final stages of life and, at best, can only be managed. Regardless of the root cause, the primary goal of treating terminal restlessness should always be to keep the patient safe. Installing safety rails to their bed and keeping a close eye on them can help avoid falling accidents.

Watching a loved one go through terminal restlessness can be emotionally draining as a family. At Cura-HPC we offer bereavement counseling to patients’ family members as one of our hospice care services. We believe hospice and palliative care is meant to take care of the entire family. If your family is in need of hospice services, call Cura-HPC. 

While medical researchers have made great strides in cancer research, there often comes a point in which treatments are no longer effective and remission is out of reach. When a patient reaches this point, hospice can be a great benefit. The goal of hospice care for cancer patients is not to cure the disease, but rather to do whatever we can to make the patient comfortable in their final stages of life. This palliative care approach can often increase the patient’s quality of life and offers several other benefits.

Financial Assistance

Going through cancer treatments can be expensive even with the best insurance. Thankfully, hospice care is a Medicare benefit, which means patients and their families rarely have to pay anything out of pocket for hospice care.

Pain Management

A very common service provided to hospice patients with cancer is pain management. Hospice teams are specially trained to help patients cope with the physical and mental effects of chronic pain. When pain becomes very severe, we can offer 24/7 care, called continuous care, to ensure the patient’s pain is managed.

Bereavement

Hospice and palliative care is designed to treat all the needs of a patient, not just the physical symptoms. With that in mind, bereavement counseling is offered to patients and their families. This service can help everyone cope with the grief and depression that can accompany end of life care.

Respite Care

Caring for a loved one while they have cancer, or any terminal illness, can be exhausting. To help family members get a break from the demands of caregiving, hospices offer respite care. This is a level of care that allows the patient to receive up to five days of inpatient care to give the family caregivers some time to rest.

Going through end of life care and switching to a palliative care method can bring about some uncertainty. If you have questions about hospice care for cancer patients, please give Cura-HPC a call. One of our staff members will be happy to assist you and answer any questions you may have.  

Simply defined, palliative care (pronounced pal-lee-uh-tiv) is a special form of medical treatment designed for patients with serious illnesses. The goal of palliative care is not to cure the illnesses, but rather to alleviate the symptoms and make the patient as comfortable as possible. Palliative care is most commonly applied in a hospice setting for terminally ill patients.

Quality of Life

By treating the pain and suffering caused by terminal illnesses, palliative care professionals are able to improve the patient’s quality of life. This treatment method isn’t only focused on physical pain; it also includes mental health symptoms like grief and depression.

A Team Effort

Palliative care is typically administered by a team of end of life care experts. This team includes a medical director, nurses, social workers, aids, bereavement councilors, and even volunteers. A palliative care team will often work in conjunction with other medical professionals such as a patient’s primary care physician. This team approach offers a comprehensive plan for end of life care.

Not Just the Patient

One of the more unique aspects of palliative care is that it is designed for the entire family, not just the patient. Helping a loved one through end of life care can take an emotional toll on a family, which is why bereavement and grief counseling are offered to family members of hospice patients during the patient’s enrollment and for 12 months after the patient passes away.

Making the decision to switch from a curative style of medical treatment to purely palliative care can sometimes be a tough decision. Families often feel like they’re giving up on their loved one. However, it’s important to remember that palliative care will increase the patient’s quality of life and you will have access to medical professionals who specialize in managing end of life symptoms like chronic pain and depression.

If you have questions about palliative care or are in need of a Tulsa hospice for your loved one, please call Cura-HPC today.

Being named as a health care proxy for a loved one is an incredible responsibility. You will have to be an effective decision maker and potentially make some hard calls. If you find yourself in this situation and are feeling a bit overwhelmed, here are a few tips.

Know What They Value Most

It might be an uncomfortable conversation to have, but understanding what you loved one values during end of life care will help inform your decision making. Find out if they prefer to be at home or in a hospital, if they want life support, and if there’s any kind of treatment they do not want to undergo.

Plan Ahead

Trying to answer a difficult question at a moment’s notice will only add to your stress. To eliminate this stress, try to think through as many situations as you can and decide what you want to do if that happens. Obviously, you won’t be able to prepare for every situation, but the more prepared you are, the easier it will be.

Talk with Family Members

You might have to make a decision your family members don’t agree with, and you need to be ready for those conversations. Having these conversations in advance will give you time to explain your reasoning and allow family members to slowly accept your decision, should it come to that.

Being a health care proxy can feel overwhelming. That’s one of the reasons we offer bereavement counseling to patients and their family members. This counseling can help you cope with the stress and grief of making these tough decisions. 

Being a caregiver for a dying loved one can be a fulltime job. With all the responsibilities and emotions involved in caring for a loved one, sometimes caregivers just need a break. This is a common problem and Medicare created a level of care called respite care to meet this need. With respite care, family caregivers get a break from their caregiving duties while the patient is cared for in a Medicare-certified inpatient facility.

When is Respite Care Allowed?

The official Medicare definition of respite care is, “short-term inpatient care provided to the individual only when necessary to relieve the family members or the person caring for the individual at home.” Qualifying events include:

• Caregivers becoming sick
• Emotional or physical fatigue from continually caring for the loved one
• Needing to attend an important event such as a wedding, jury duty, graduation, or funeral

How Does Respite Care Avoid Burnout?

When a patient is accepted for respite care, Medicare will pay for them to stay in a Medicare-certified facility for up to five days. This provides family caregivers with some free time to rest and get recharged. Knowing the patient is receiving around the clock care from trained professionals can come as a great relief to caregivers who have spent months as the primary caregiver for the patient.

Who Cares for the Patient?

While in the care of the Medicare-certified facility, the regular hospice team will continue to administer the care plan they created, while the facility staff members will fill the role normally played by the family caregiver.  

We understand that caregiver burnout is a real thing, which is why we encourage family members to take advantage of respite care when qualifying situations allow. At Cura-HPC, we want to help families through this difficult time by limiting the emotional stress and physical demands of having a loved one in hospice care. If you need hospice care for your loved one, please call Cura-HPC.

The World Health Organization defines palliative care as, an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

To put it simply, the goal of palliative care is to make the patient as comfortable as possible. As you might imagine, a large part of making patients comfortable is managing the chronic pain that often accompanies end of life care. Not every hospice patient will experience chronic pain, but the hospice team at Cura-HPC will assess the patient’s pain level on a regular basis to see if any care plan adjustments are needed.

To assess the patient’s pain, there are several scales a hospice team can use: 0-10 Numeric Pain Rating Scale, the Wong-Baker FACES Pain Rating Scale, and the FLACC scale. Each scale has its own advantages and will be used to best assess the pain of the patient.

Once the level of pain has been assessed, we can start treating the patient. A common pain management technique is using medication. By using the right dosage and type of medication, we can block the pain receptors in the brain and decrease the feeling of pain. Some of the most common types of pain medications used to treat chronic pain are:

• Morphine
• Oxycodone
• Methadone
• Hydromorphone

Anytime medication is used, we take precautions to ensure patients are not over medicated. While we want to manage the pain as much as possible, we also want patients to be coherent enough to spend meaningful time with their family.

Another method used to treat pain is by tending to the emotional symptoms of pain. Depression and anxiety are often associated with end of life care, and these two factors can worsen the physical pain a patient may be experiencing. By offering grief counseling and bereavement care, depression and anxiety can be better managed.

If your loved one is in need of hospice and palliative care, call Cura-HPC. 

Planning a funeral for a loved one can be incredibly stressful and frustrating if you’re not careful. While this process won’t likely be enjoyable, there are steps you can take to reduce your stress level and avoid frustration.

Plan Ahead

The more time you have to plan, the easier it will be. As your loved one begins to age and their passing becomes more and more evident, you can start making preliminary funeral plans. You can even take this time to ask for input from your loved one if you feel like they will be receptive to that kind of conversation.

Don’t Do it Alone

Don’t be afraid to delegate certain tasks to other family members or friends. This will allow others to have their voices and input heard during the planning process and it takes duties off your plate so you don’t feel so overwhelmed.

Ask as Many Questions as You Want

Funeral directors are a great resource to use when planning a funeral. They are particularly good at answering all your funeral related questions, so don’t worry about asking too many. If you’re unsure or curious about something, don’t hesitate to ask.

Talk to Someone

The combination of planning a funeral and dealing with the death of a loved one can take a toll on your emotional state. Cura-HPC offers bereavement counseling for a patient’s family that is available for 12 months after the patient passes. This service can help you deal with the emotions you’re going through and process what you’re feeling.

If you’re looking for a Tulsa hospice provider, call Cura-HPC. 

Thanks to advances in technology, making a high-quality home movie is easier than ever. This means graduations, little league games, family reunions, and Christmas mornings can all be documented and preserved for generations to come. Easy DIY home videos have also increased the popularity of legacy videos.

What is a Legacy Video?

In lieu of a scrapbook, some families have started making short documentary-style movies, called a legacy video, to document their aging parent’s life and achievements. These videos will normally consist of casual interviews with the aging parent, their children, and their friends. It can also include some old photos along the way to illustrate their life.

How to Make a Legacy Video

The first step is to get your equipment squared away. Using your smartphone will be the easiest option, but you can upgrade to a DSLR camera with a video function if you want. Regardless of the camera, you’ll probably want to invest in a good mic and tripod. These two pieces of equipment will make a huge difference in the quality of your video, and you can pick up both for a pretty reasonable price. They even make tripods and mics for phones! Here are some quick tips for shooting great iPhone footage.

Next, you’ll want to make a list of people you want to interview. It’s best to give your interviewees a list of questions and prompts you’ll be asking them ahead of time so they can plan their answers. Scheduling interviews around holidays and family gatherings is an easy way to knock out a lot of interviews in one day.

While you’re working on getting all the interviews, you can also ask people for photos and memorabilia. This can take a while so it’s best to start this process early. Ideally, you’ll want to get photos of the events and stories that are being discussed in the interview.

Now the only thing that’s left to do is put it all together, which isn’t as easy as it sounds. Before you start, it’s best to think about all the stories you’ve heard and try to write out a rough outline of the narrative you want to tell in the video. This will save you a lot of time sifting through footage.

Legacy videos allow families to remember their loved ones after they pass, and they can even help the grieving process. Getting to hear their voice again and learn about all the great things they did in their life can be a great comfort. 

Fear of public speaking is among the most common phobias in Western culture, often coming in ahead of dying. So the combination of death and public speaking can easily rattle a person’s confidence. When putting together a eulogy, it’s not uncommon to struggle. The good news is that there’s no right or wrong way to start. You can take your eulogy in just about whatever direction you feel. However, it can be helpful to have a bit of structure to follow when putting pen to paper.

Here are a few guidelines you can use to write a eulogy.

Start with the Introduction

It might seem unnecessary, but it’s normally a good idea to start by introducing yourself and defining your relationship with the deceased. Talk about how long you’ve known them and how you met.

Pick a Direction

This can be the hardest step to complete. As previously said, there are a lot of directions you can take a eulogy. You can tell your favorite story about the deceased that you feel best describes them. You can talk about what you admire most about them. Or you can say what you’ll miss most about them. When picking the direction, just ask yourself ‘what’s the one thing I want everyone to know about them?’ Once you’ve answered that question you can figure out what style offers the best solution.

Pick a Theme

Now that you know the style of eulogy you’ll be using, pick a theme. You can use a central theme to tie all the stories, introductions, and images you plan on talking about. The theme could be an answer to a question, the deceased favorite catchphrase, a defining moment in your relationship, or whatever you feel best defines their life.

Practice and Have a Backup

Once you’ve finished writing, make sure to do a few practice runs. It might feel strange, but saying the eulogy out loud at least once will help you iron out any awkward phrasings. No matter how confident you feel the day before, ask someone to be your backup just in case you can’t make it through the entire speech. 

In an effort to sympathize, empathize, or just relate to grieving friends and family, we often compare their grief to a time in our own life when we were grieving. This process can yield some helpful results such as common ground or lessons learned from past experience, but all too often the results and side effects aren’t great.

When we compare grief it’s very easy to compare timelines as well. We want to compare our grief to others to see if the way we’re handling the current situation, or handled the past situation, was in line with cultural norms. The only problem is that you’re comparing apples and oranges because no two grief stories are the same.

The circumstances surrounding the death might appear to be similar, but the relationship individuals have with the deceased are never the same, nor are the ways our personalities have been conditioned to handle grief.

Say one of three brothers passes away. The other two brothers will deal with the loss in two very different ways, even though it appears they went through the exact same situation. One brother might be closer than the other, one brother might be more naturally prone to depression, and there’s a long list of other factors that contribute to how we process grief.  

Comparing grief can cause us to be frustrated with others who don’t get over it as fast as we do or feel weak because we’re taking longer than others to adjust. Neither situation is conducive to coping with grief, so it’s best to avoid this practice.

Instead of comparing grief, try to focus on the why. Why are others dealing with grief the way they are? Why are you dealing with grief the way you are? You must answer these questions independently of each other. Only focus on one grief at a time. 

Families often look for ways to commemorate and memorialize their loved one’s life when they enter hospice care. One great way to do this is by creating a life book. These books are made up of a person’s life history, heritage, cherished stories, and advice for posterity. Making a life book not only gives the family a tangible keepsake to remember their loved one by, but the process of putting the book together can also be very therapeutic.

Make the Framework

The first step is to create a loose framework of the outline of the information you want to include in the book. Get a list of questions together and major events you think might paint a good picture of your loved one’s life. Remember, this is just a framework, and you’re likely to find more information you didn’t think of after talking with your loved one, so don’t hold on to this framework too tightly.

Some good general categories to start with are: where they grew up, what their childhood was like, where they went to school, how they met their spouse, what it was like to raise children, what they did for a living, the most important advice they ever heard, the happiest moment of their life, the craziest thing they ever did, favorite hobbies, and how they hope to be remembered.

Start with What You Already Know

Now that you have a framework, start filling it in with what you already know. Once you fill out everything you know, start asking friends and family to help fill in the gaps. This is also a great time to ask others if there are any other bits of information they think would make good additions to the book.

Set Up the Interview

After talking with friends and family it’s time to schedule a sit down with your loved one and talk with them about their life story. You’ll want to pick a time when you can have their full and undivided attention. It’s also a good idea to break up this interview process into a couple meeting so no one gets overwhelmed. Run through your list of questions and carefully write down or record their answers.

Putting it Together

You have two basic options when you’re putting all the information together – digital or print. If your tech savvy enough, you can use a variety of web-based memory book making services. These programs usually don’t charge you to put the book together, just to print it. If computers aren’t your thing, then head to the craft store and stock up on construction paper and scrapbooking supplies. Whichever way you go, it’s best to tell the story in chronological order and try to get as many pictures as possible.

Children process grief much differently than adults do and it’s important to offer age-appropriate grief support. One of the most difficult hurdles to overcome with grieving children is communication. A child who is still developing communication skills can have a hard time expressing what they’re feeling and tend to just shut down. If this happens to your child after experiencing the loss of a loved one, know that this is normal. Here are three ways you can breakthrough and help your kid through grief.

Get Back to Routine

Returning to your normal routine might seem counterintuitive, but most children do well with a consistent routine. You still need to give them time to morn and process, but jumping back into your regular schedule after a few days can restore a sense of normality for your child.

Create Activities

Creating a fun activity for the kids can be a great distraction from grief. Let them pick a new paint color for their room and have them help you apply a fresh coat. Go get a new board game and have a game night. Set up a TV in the backyard and watch their favorite movie under the stars. Anyway you can take their mind off it for a little while is a win.

Don’t Forget to Talk

Getting back to normal and finding new activities is good, but you still need to make time to talk about what happened. Carve out time to make sure you’re checking on their emotional state. Ask how they’re feeling and if they have any questions about death. It might be a short conversation, or it could be a long talk. Whatever the length, just make sure they’re processing everything in a healthy manner.

If you have concerns about their emotional state or mental health, remember that Cura-HPC offers bereavement counseling to family members for 12 months after a patient passes away. Our bereavement specialists would be happy to talk with you and your children to help guide your family through grief. 

When patients don’t stipulate their healthcare wishes in an advanced directive, families will have to use their own discernment to make decisions about the loved one’s care plan. This can be kindling for some sharp disagreements and tough conversations. Even families with great relationships can struggle to make these kinds of decisions. However hard, these decisions need to be made in a timely manner to provide the proper level of care for the patient.

To help families negotiate these decisions, hospices will provide a social worker and chaplain who can offer advice and counsel families through this difficult time. One of the most important things to do during this time is to ensure everyone’s voice is heard. It might seem inefficient to seek so many opinions, but it’s vital that everyone who cares for the patient feels like they’re opinion matters.

Holding family meetings instead of playing phone tag is a great way to make the process run more smoothly. Getting everyone in the same room lets ideas and emotions flow organically and typically renders a final decision faster than other options.

Setting an agenda and appointing a facilitator for these meetings will be of great benefit. Doing so gives needed structure to a chaotic and confusing time for the family. However, don’t be afraid to go off script a little to validate other people’s emotions. Family members will likely be feeling emotions they’re not used to dealing with and you don’t want to overlook that.

Although it would be nice, not all decisions will be unanimous. People will disagree with others, and that’s okay. Go with the majority and do what you can to build consensus with the dissenting members. Let them know you appreciate their input and want to keep them involved in the process with future decisions that need to be made.

We have trained staff members ready to help families in times like this at Cura-HPC. If your loved one is in need of hospice care, please give us a call. 

When a family member requires around the clock care, it can put a lot of stress on family members. Caregiving is often a full-time job, and when you’re a full-time caregiving on top of working your regular full-time job, stress, anxiety, and depression can easily creep in. This can test caregivers’ physical and emotional boundaries.

High levels of stress and fatigue associated with caregiving are so common that the term caregiving burnout was coined. This condition is incredibly common among family members who are acting as their dying loved one’s sole caregiver.

Every situation will be different, and the size of the family can have a big impact on caregiver burnout. When there are multiple family members willing to pitch in and help take care of the dying loved one, caregiver burnout tends to be less of a risk. On the other side of the coin, higher rates of burnout are seen when only one or two adult children are taking care of a dying parent.

How to Avoid Burnout

There are two steps that must be taken to avoid caregiver burnout – get help and don’t feel guilty. If you’re feeling like you’re getting burnt out, you probably are. This means it’s time to get some extra help. The good news is that there’s a good chance of qualifying for financial assistance through Medicare. Acknowledging the negative effects of caregiver burnout, Medicare offers caregiver support through home health aides and skilled nursing at a free or reduced cost.

Not feeling guilty is the second step to take, and it’s not as easy as you might think. While caregivers might fantasize about having a night off, they often feel guilty about not being with their loved one once they finally get one. It’s important to understand they your loved one is in good hands and will be taken care of. You don’t have to be by their side 24/7. 

The funeral traditions in the states have stayed the same for many years now. We have a viewing, possibly a religious ceremony, and then a graveside service if the body will be buried. Cremation is also an option for those who don’t like the idea of a coffin. Keeping things the same might sound cliché to some, but it’s actually pretty helpful to have a sense of familiarity when families are going through a difficult, and often unfamiliar, time.

The funeral traditions in America were established over many years and, while they seem normal to us, they are quite different than funeral traditions around the world. Below is a small sample of some unique funeral traditions found in other cultures.

Jazz Funerals

We’re not going too far away from home for this first one. Down in the Big Easy a jazz funeral is a common site. This tradition became popular in New Orleans thanks to the mix of African and European cultures in the city. A jazz funeral starts with a march led by family, friends, and a brass band and ends at the cemetery. The band will play somber music, called a dirge, during the march, but will switch to more upbeat music once the procession leaves the gravesite. The purpose of switching to upbeat music is to have a lively celebration of the life of the deceased.

Custom Coffins

There isn’t a lot of coffin design variation in America, but that’s not the case in Ghana. In this little African country coffins are custom made to reflect the deceased’s personality and hobbies. A coffin can be in the shape of a race car, animal, shoes, airplanes and just about anything that can be made out of wood. Making these custom coffins can take months, which often delays funerals.

Burial Beads

Due to limited cemetery space in South Korea, the price of a burial is incredibly expensive. This high price tag forces most families to cremate their loved ones, but the ashes are made into colorful and decorative beads instead of keeping the ashes in an urn. Families can display these beads around the home. 

Tree Burial

Living trees serve as a burial site in certain regions of the Philippines. When a member of the community is nearing death, they will pick a tree in the forest and their family members will build a hut next to it. The dying person will live in this hut while their family works to hollow out a space in the trunk of the tree. Once the loved one has died, they will be vertically entombed in the trunk of the tree. 

Over thirty-four million Americans are caregivers to family members, and many of them do so from a distance of an hour away or more.  Thanks to advances in technology, assisting seniors from afar is getting easier. 

Statistics show that the American population is aging, and the oldest of the senior population is the fastest-growing group.  Naturally, members of that demographic often suffer from debilitating health issues, and care for those issues is expensive.  Most older Americans prefer to age in place, and with technological products and services, it is becoming easier for caregivers to arrange that, and even saves money over alternatives.  According to The Economist, using goods and services to help seniors stay home can improve quality of life and helps prevent expensive hospital stays.  Here are some of the available options.

Products

Wearables.  Wearable devices that resemble traditional wristwatches provide seniors with activity trackers, medication reminders, and safety assistance.  Lively offers a safety watch, and Wisewear offers stylish bracelets in a few different designs to suit a user’s sense of style.

Voice-activated devices.  Gadgets such as the Amazon Echo allow seniors to turn on and off lights, change the temperature on the thermostat, and turn on and off garden sprinklers. 

Apps.  Professionals from Provider Magazine recommend apps like CareZone to help caregivers stay organized and coordinated with family members, doctors and other providers.  Users can manage medications, track health conditions, coordinate appointments, organize health care information such as insurance and physicians, and communicate by sharing files, photos and notes. 

GreatCall Link monitors daily activity and alerts family members when something is wrong.  It also can notify highly-trained emergency personnel, if needed. 

The National Alzheimer’s Center created Balance especially for Alzheimer’s caregivers.  This app facilitates coordinating between multiple caregivers and tracking common behavioral and emotional symptoms, and keeps caregivers informed of related health news. 

Monitoring systems.  These systems employ sensors in seniors’ homes to track their daily activity.  Sensors can be attached throughout the home to various objects like doors, appliances, cabinets, medicine chests and bedding.  They learn normal activity patterns and alert caregivers if seniors deviate, such as wandering outside late at night or not making breakfast in the morning.  The GrandCare System is one that the experts at AgingCare suggest. 

Services

Some cities lend themselves particularly well to aging in place, thanks to the technology-based services they offer.  Connecting with various agencies can assist elderly people with remaining independent.  Commuting services such as Uber allow seniors to run errands and visit friends.  Pet care can be hired through websites such as Rover.com, and lawn care can be arranged from services such as Porch.  If a senior can’t manage groceries alone, there are shopping and delivery services like Instacart, and in-home care can be arranged through providers such as CareLinx.  For seniors uncomfortable with technology, a family member or friend can make arrangements for them.  According to the experts at Redfin, seniors can save money with this kind of arrangement:

“For seniors who need basic assistance and want to remain at home, these services are an attractive option. And, depending on the amount of care required, they can be a more affordable option as well. For example, in Washington D.C., a resident could spend $3,000 on care services and $2,787 on their mortgage, and still spend less than the $5,933 it would take to live in an assisted living facility.”

Aging in place is getting easier

The population is growing older and the vast majority of people prefer to age in place.  Caregivers are connecting with products and services to make this a possibility, improving quality of life for seniors and reducing hospital visits.  In the long run, seniors and their support system save money.  Thanks to these advances, life is getting better for the elderly and their caregivers. 

The new year is almost here and people everywhere are making resolutions to improve their lives. Those with terminally ill loved ones should take this opportunity to make resolutions to not only improve their own quality of life, but also their loved one’s quality of life. Here are a few easy ways you can commit to improving the care you give your loved one.

Just Talk

One of the easiest ways you can have a big impact on a terminally ill patient is just talking with them. It might seem hard to talk with your loved one, especially if they have a weakening voice or dementia, but verbal interaction can lift spirits and improve mental health.

Aim Small

Caring for a terminally ill patient can be exhausting and it’s easy for little things to go unnoticed. However, taking care of minor issues can make a world of difference for the patient. A minor issue that goes unnoticed all too often is hydration. Ensuring your loved one is drinking enough water can improve the effectiveness of treatments across the board.

Be Adaptive

One of the most important parts of end of life care is allowing the patient to still do the activities they enjoy. Due to the limitations of their illness, you’ll most likely have to get creative and adapt their favorite activities. For example, if your loved one loves going to baseball games, but can’t make it to the stadium anymore, watch the game on TV and make it feel like the stadium. Get everyone to wear hats and jerseys, grill hot dogs, take a seventh-inning stretch, and heckle the opposing batters.

As you can see, hospice care new year’s resolutions don’t have to involve a lot of effort or time to achieve. It’s really just about being aware of how little changes can add up to a big difference. What resolutions are you setting this year? 

More than 54 million Americans over the age of 50 have been diagnosed with osteoporosis. This disease causes the bones to be brittle and fragile as a result of low mass and tissue. In a healthy body, the bone tissue is constantly being broken down (a process called resorbed) and then reformed. This process happens so frequently that healthy bodies actually replace their entire skeleton every 10 years.

As our bodies grow during our childhood, our bones reform faster than they resorb. However, this imbalance switches when osteoporosis hits later in life. This disease occurs most frequently in older women, causing one in two women to break a bone as a result of osteoporosis.

Risk Factors

The National Osteoporosis Foundation has identified several key lifestyle factors that can increase the chances of developing osteoporosis. Two of the biggest risk factors are lack of exercise and calcium in your daily diet.

Our bones become stronger in response to strength training like lifting weights. Those who do not engage in regular exercise and lead sedimentary lifestyles can increase their chances of an osteoporosis diagnosis. Our bones also need a steady supply of calcium to support the reforming process. Regularly eating calcium-rich foods like yogurt, almonds, and milk can be a great defense against osteoporosis. Other risk factors include smoking, having one or more alcoholic beverage a day, and consuming more than 30oz of coffee a day.

Prevention

As with most diseases, the best way to prevent osteoporosis is as simple as a healthy diet and regular exercise. As stated above, weight training and a calcium-rich diet are the best way to curb the effects of osteoporosis. It’s never too early to start thinking about osteoporosis prevention, especially for young women. Taking steps at a young age to prevent osteoporosis is much easier than trying to treat the symptoms after the disease has set in. 

Writing an obituary for a friend or family member isn’t as easy as some may think. While you likely know this person extremely well, summing up an entire life in a few paragraphs can seem daunting. There’s an underlying pressure to get it just right and do right by the deceased to ensure every reader fully understands who they were and how special they are.

This pressure is the first hurdle to overcome. It’s important to understand that not even Hemingway could adequately describe the full grandeur of a person’s life, so don’t put that burden on yourself. The purpose of an obituary is simply to inform the public of the passing, and to briefly tell their story.

The boilerplate information is often a good place to get started. Age, the cause of death, job, education, family, hometown, and places they’ve lived can serve as low hanging fruit to start writing. From there you can get more detailed by talking about any military service, hobbies, education, interests, anything they were particularly passionate about, community involvement, and church membership.

Now that the basics are out of the way, you can move on to describing personality traits and discussing who the person really was. To do this, it can be helpful to talk with other friends and family members to see how they described the deceased. Look for trends with words used in the multiple descriptions, and use these trends in the obituary. Once you’ve identified the right words to use, try to find a story that exemplifies these characteristics.

An obituary doesn’t have to be anything fancy, but you can make it as intricate as you feel the deceased would have wanted. It can be helpful to try to write the obituary as they would have written it. If they would have cracked a few jokes, then crack a few jokes, but if they were more reserved and dry, keep it simple. Whichever way you go, just remember to tell the basics and then move onto the details. 

As the Christmas season approaches, families with a loved one in hospice care might be struggling to make holiday plans. If you find yourself in this situation this season, know that this year will be different than years past, but you can still enjoy the holidays with a little planning. Whether your loved one is receiving home hospice or in an assisted care facility, here are a few things you can do to make Christmas special for the entire family.

Home Hospice

Spending Christmas with a loved one in-home hospice care is a balancing act between maintaining traditions and not overstimulating. It’s important to continue traditions and let everyone, including those getting hospice care, enjoy the traditions that are important to your family. However, overstimulating hospice patients with lots of people, sounds, and activity can cause your loved one to tire quickly and feel uncomfortable.

 Assisted Living Facility

Although your loved one might not be celebrating Christmas in their home, that doesn’t mean you can’t make it feel like home. Bring some decorations over for them and add some holiday touches to their living space. If there are special decorations like an angel tree topper or snow globe collection, make sure to bring those over. For the morning of festivities, it might be best to limit the number of people who come over or plan shifts so you don’t overwhelm them. Their living space might not be able to handle a big group of people and large groups can also overstimulate the patient.

If different family members are coming in shifts, this can be a great opportunity for each group to cook a favorite dish and bring it with them. This lets everyone still have a meal with your loved one and lets them maintain a consistent nap schedule.

It might not seem like Christmas and hospice mix, and this might still be an emotionally difficult year, but you can still make this Christmas special. Whatever you plan on doing, check with your hospice medical team to make sure it won’t interfere with treatment. Your hospice team might also be able to help you with a few things, so it never hurts to check. 

As our loved ones get older, falls become more and more of a hazard. The National Institute on Health reports that falls cause more trauma-related hospital admissions, fractures, loss of independence and injuries for older adults. Numbers like these make you realize just how susceptible seniors are to falls and how serious of an issue falls are. Thankfully, there are ways to recognize fall risks and take appropriate action.

Aging

One of the biggest, and possibly most obvious, factors that can lead to falls is aging. As we get older our reflexes get slower and our sense of balance diminishes. This combination can turn a small slip into a big fall. Another aging factor is weak leg muscles. This can happen as seniors become less mobile and the muscle strength in their legs gets worse.

Medication

Studies have shown that the more medication a senior takes, the more likely they are to experience a fall. This happens because a lot of medications commonly prescribed to seniors have side effects like dizziness, confusion, and impaired brain circulation.

Preventing Falls

The best way to prevent falls is to identify the most likely causes and act appropriately. If falls are being caused by balance and reflex issues, exercise classes that focus on improving these functions can be a huge help. A geriatrician can also review all medications to help curb the negative effects of medications.

One of the best ways to help seniors avoid falls is to buy a cane or walker. This allows them to retain mobile and maintain their muscle strength, but also gives them more sure footing in case of a slip or momentary loss of balance.

Falls are common among seniors, but they don’t have to be. By being proactive and spotting the early signs you can help your aging loved one avoid falls and stay out of the hospital. 

When it comes to end-of-life care, there are many symptoms that are misunderstood. One symptom that is well known, but not well understood, is terminal respiratory secretions. Commonly referred to as a death rattle, this symptom involves noisy breathing and tends to raise several questions from family members.

The cause of terminal respiratory secretions, or death rattle, is a build up of mucus and saliva in the patient’s throat. In many cases, terminally ill patients will eventually lose the ability to swallow and clear their throat. As they begin to lose consciousness, this build up will stay lodged in their throat, moving in time with the patient’s breathing. This movement causes a crackling and rattling sound.

How to Care for a Patient with a Death Rattle

Terminal respiratory secretions aren’t always an indication of respiratory distress, but the sound can often raise concerns from the family of the patient. There are a few medications, such as Hyoscyamine (Levsin) and Atropine, that can be administered to decrease the patient’s saliva production. Another way to treat terminal respiratory secretions is to reposition the patient on their side and raise their head to help the patient be more comfortable.

Although death rattles aren’t a pleasant sound for families to hear, it is a natural part of end-of-life care. When a patient begins to experience this symptom, it’s normally an indication the patient is nearing the end. This can be a cue for family members to come say their final goodbyes, and for our bereavement consolers to come meet with the family to help guide them through this time.

If you’re in need of hospice care in Tulsa or the surrounding areas, call Cura Hospice and Palliative Care. Our team of hospice professionals is here to help your loved one deal with symptoms like terminal respiratory secretions and other common end-of-life symptoms. 

As the busy holiday season approaches, those who have recently experienced a loss are likely dreading the traditions they formally enjoyed with their deceased loved one. This holiday season will not be like years past, and that’s okay. The roles that your loved one use to play will have to be filled by someone else or left unfilled. This can be a harsh reality to face, but you need to remember that it’s okay to feel sad during this time.

Gathering as a family for the first time without your loved one can bring on strong feelings of grief and even depression. These feelings are all legitimate and need to be acknowledged. If you think this holiday season might be a tough one, be sure to not take on too much responsibility. Talk with other family members and divide the workload according to everyone’s emotional capacity. If no one is feeling up to cooking the turkey or making some dish that’s normally a family favorite, don’t feel obligated to volunteer. It’s okay to make a few adjustments here and there to accommodate everyone’s needs.

During this gathering, it might be tempting to ignore the loss and focus on more positive aspects of the day. However, acknowledging the loss, even if it’s very briefly, can help everyone process what happened and even give the family a sense of unity and mutual support.

One great way to do this is to create a new tradition that honors your lost loved one. Bringing fresh flowers to the grave site, playing an honorary baseball game, giving a special toast before eating, or even just lighting a candle are all great ways to honor and remember your loved one for many years to come.

This first year won’t be easy, but know that each coming year will get easier and easier. Remember and be thankful for the times you had with your loved one and do your best to create more memories with the loved ones around you this year. 

Most people are vastly under-educated about the effects and scope of depression. Every year, more than 350 million people are thought to be affected by depression. The causes of depression are just as wide-ranging as the types of people it affects. No one, regardless of age, gender, socioeconomic level, or genetic history, is invulnerable when it comes to depression. One demographic that is particularly susceptible to depression is the terminally ill.

Dealing with grief is a ubiquitous experience during the final stages of life. However, this grief can easily turn into clinical depression if left unchecked. Thankfully, depression is a treatable condition, even in terminally ill patients.

The first step to treating depression in terminally ill patients is recognizing the symptoms. These symptoms are very similar to symptoms found in non-terminally ill patients. If you think your loved one is experiencing or may be on the verge of experiencing depression, look for changes in their mood, sleeping, appetite, weight, behavior, and cognition.

It’s important to remember that these changes can be caused by a myriad of other factors, so be sure to check with the attending physician before sounding the alarms.

Once depression has been identified as the root cause of these changes, there are several treatment options available. Medication and counseling are the two primary treatment options for depression. The hospice chaplain and bereavement consoler will be a fantastic resource for any hospice patients experiencing depression.

These counseling services are also available to the family of the patient, because depression doesn’t just affect the patient. Seeing your loved one go through the last stages of life and coping with their impending death can take a real toll on family members. This is why family members also need to vigilant to be spot depression.  

When people think about dealing with the loss of a loved one, most people will consider the five stages of grief at some point. This system was created by a Swiss-American psychiatrist named Elisabeth Kübler-Ross in 1969. In her ground-breaking book, On Death and Dying, the world was first introduced to the five stages of grief – denial, anger, bargaining, depression, and acceptance. For almost 50 years, this has been the gold standard for dealing with grief. However, some grief experts are starting to move away from this model.

While the five stages have been incredibly helpful for people experiencing loss, the method has become so widespread that people have started to misuse it. The word “stages” suggests that grief is a linear process with a predictable path. There are certainly common emotions and conditions shared by those dealing with a loss, but that doesn’t mean grief will always take the same path.

Instead of trying to figure out what stage you’re in, just be aware of the symptoms of grief and treat them as they come. Grief will affect every aspect of your life, and it’s normal to experience physical, emotional, and spiritual symptoms. Knowing what these symptoms look like will help you treat them and ultimately get past them.

Physical Symptoms of Grief

• Trouble sleeping
• Fatigue
• Weight changes
• Headaches
• Muscle tension
• Decreased immune system

Emotional Symptoms of Grief

• Low self-esteem
• Indecisiveness
• Negative thoughts
• Trouble concentrating
• Thinking you are responsible for the loss
• Nightmares
• Paranoia
• Feeling isolated

Spiritual Symptoms of Grief

• Questioning your beliefs
• Being angry at God
• Questioning your purpose
• Feeling abandoned

These symptoms could very well follow the traditional five stages, but treating symptoms as they come will likely be more helpful than trying to pinpoint which stage you’re at. Use the five stages as a guide, but don’t feel tied to them. Most importantly, don’t be afraid to get help if you need it. Grief counseling or support groups can be incredibly helpful.

There will likely come a time in which you have to make the difficult decision to move your parent, spouse, or another family member into an assisted living or nursing home or let them remain in their home alone. When moving your loved one in with you isn’t an option, it can be hard to know whether your loved one is capable of safely living on their own.

The looming risk of a fall or unexpected health emergency like a stroke or heart attack will always be there. To complicate things even more, few seniors are excited about the prospect of moving out of their home and into a nursing home.

So, how can you know if your loved one is stable enough to live on their own?

The key to answering this question is balancing safety and preferences. Obviously, you’ll want to make sure your loved one is living in a safe environment, but you also want to ensure their wishes and preferences are taken into account. There are four factors to consider when balancing safety and preference.

Memory

Do they remember to take all their medication every day? Are they remembering to eat and drink on a regular basis? Have they gotten up from bed to use the bathroom and forgotten how to get back to bed? Do they still recognize family members and old friends? Memory tends to fade gradually, so it won’t be a sudden switch. Keep an eye on their memory to make sure they can still adequately take care of themselves.  

Sleeping

Sometimes elderly people fall asleep without intending to, and this isn’t a problem in most situations. However, if they fall asleep with the stove on or with a lit cigarette in hand, it can be very dangerous. An occasional accidental snooze while watching the game doesn’t need to sound any alarms, but you’ll need to pay closer attention as this habit becomes more frequent.

Falling

This is a caregiver’s worst nightmare. Elderly people can become prone to falls and they can spend hours on the floor if they live alone. Getting a Life Alert necklace or similar emergency product can be a happy medium for a while, but onsite help will eventually be required if falls continue.

Calling

One factor that is frequently overlooked, is the loved one’s willingness and ability to call when they need help. If they are not willing or able to call you when they need help with something, and tend to stretch the bounds of their independence, they can put themselves in precarious situations. The difficult part is that people who fall in this category tend to be the most resistant to moving, but you have to do what’s best for their safety. 

Smoking is a nasty habit, and we’re all well aware of the negative health effects. The CDC estimates smoking will take 10 years off your life and most likely be a strong contributing factor to your death. However, while the question of starting to smoke should always be answered with a resounding no, is it okay for a patient to keep smoking once they enter end of life care?

The answer to this question is, maybe.

The goal of hospice and palliative care is to make the patient as comfortable as possible, not trying to cure the patient. So, if a patient is already suffering from multiple symptoms, aches, and pains, is it right for them to go through the unpleasantries of kicking the habit? In most cases, patients who are already addicted to smoking can keep smoking, provided it’s done safely.

Smoking poses several risks that need to be addressed if a patient wants to continue lighting up. The first risk is an oxygen tank, that is commonly given to hospice patients to assist them with breathing. These tanks contain 100% oxygen, which is highly flammable. If a patient smokes while using or around an oxygen tank, they can cause an explosion that can injure themselves or those around them.

The second risk also involves fire. Since hospice patients spend a lot of time in bed, they will likely want to smoke a few cigarettes in bed. If a patient smokes in bed and falls asleep with a lit cigarette, they can catch a blanket or pillow on fire. This could cause serious injury to the patient and possibly damage the home or hospital they’re living in. If a patient wants to smoke in bed, they need to do so under the watchful eye of a caregiver to ensure no accidents happen.

Choosing to smoke while going through end of life care is a personal decision that each patient and family will need to make. Ultimately, smoking should only continue when it will improve the patient’s quality of life and can be done safely. Navigating confusing decisions like this is what we do best at Cura-HPC. If you need help finding a hospice for a loved one, or have questions about how hospice works, please give us a call. 

When coping with a loss, focusing on work can be a great way to get your mind off the grief and start to feel productive again, but this luxury is not afforded when you’re dealing with the loss of a coworker. In this situation, going back to work and sitting in meetings only brings up memories and reminds you of the loss. In times like this, it’s important that everyone in the office band together and act as a support system for each other. To provide this much-needed support, here are a few tips.

Don’t Put Expectations on Others

One quick way to make matters worse is trying to predict or put expectations on how your other coworkers should react to the loss. Just because someone was especially close to the deceased doesn’t mean they will be visibly distraught, and you might be surprised at how hard others who you thought weren’t very close to the deceased take the loss. Everyone will react differently, and there’s no sense placing your own expectations on your coworkers’ reactions.

Give it Time

It’s important for management to understand that the week or two following the death won’t set any productivity records. People will probably need a few days of bereavement and some breaks throughout the day. Bringing in a grief counselor to talk with the staff is also a good idea. Trying to rush the process and get everyone back to 100% productivity right away can prolong the process.

Open the Office to the Family

Family members are often unaware of the various relationships we have at work. They might have heard a name of a few coworkers in passing or maybe even met some coworkers at a work function, but rarely do family members fully understand the role we play at work and how we impact those we work with. Inviting the family to the office to see the deceased’s desk and get to know their coworkers can help everyone grieve together. It can also help the employees understand what their coworker was like outside of the office.

Being a caregiver for an ailing family member can take a heavy emotional toll and a heavy financial toll on the family budget. There’s the cost of medications, doctor’s appointments, and various medical equipment to consider. While most of these costs will be covered if the patient is enrolled in hospice care, these costs can be hard to cover out of pocket.

Thankfully, the IRS does allow some of these costs to be counted as tax deductible. These deductions won’t totally recoup the cost of caregiving, but they can help balance the budget a bit.

Defining Medical Expenses

According to the IRS, a medical expense is defined as, “the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body.”

Caregivers can write off the cost of medical expenses made on behalf of qualifying relatives. This includes payments made for doctors, surgeries, medical supplies and equipment, and a few other related expenses.

Qualifying Relative

As mentioned above, in order for these payments to qualify as tax deductible they must be in regard to a qualifying relative. The IRS defines a qualifying relative as, someone who the caregiver provides over half of the support for in a year and claimed a total income of less than $4,050 on last year’s tax return. Dependents can also count as qualifying relatives in most cases.

It’s important to note that the qualifications of a medical expense and a qualifying relative are both subject to change as the IRS sees fit. So, before you claim a caregiver tax deduction, make sure you’re doing so based on the current IRS standards. For full definitions and regulations, go to www.irs.gov.

There are also limits to the amount of deductions you can claim in each year. Tax deductions are limited to the amount of total medical expenses that surpass 10 percent of adjusted gross income if the taxpayer is 64 or younger, or 7.5 percent if the taxpayer or spouse is 65 or older. 

After a loved one passes away, one of the first things most people will do is send an email to their manager and/or HR director informing them of the situation and requesting bereavement PTO. This will inevitably lead to a few of your coworker learning of your loss, or at least that you had a “family emergency.” Knowing that some or all of your coworkers are aware of the situation can make returning to work difficult.

Going back to work generally presents one of two problems: wanting to return to regular routine and not being able to focus on work.

Those who fall into the first category will struggle to answer questions like, “how are you doing?” Having to discuss the loss again and again with separate coworkers and constantly hear, “I’m sorry for your loss” can grow tiresome. All you want to do is return to the daily grind like nothing ever happened, but everyone keeps bringing it up.

The issue this group of people needs to be on the lookout for is suppressing and bottling up emotions. Getting back to normal routines can be helpful, but it’s also really easy to ignore what you’re feeling and not truly process the emotions.

The second group of people may not want to be a work at all. To them, the thought of having to be away from home and family is incredibly unpleasant. Doing work-related tasks and having to put on a happy face for coworkers and clients is the last thing they want to do. No matter how much they might want to move on, thoughts of their loved one are still on their mind.

Dealing with lack of focus after a loss is expected for a certain period of time. However, if the problem continues to persist, it might be time to consider professional help. Experiencing a loss incredibly hard, and there’s no shame in talking with a grief consoler or psychiatrist. 

Strokes are one of the most common serious medical events for adults in America to experience. In fact, when it comes to American adults, strokes are the leading cause of disability and the 5th leading cause of death.  

When a stroke strikes, the blood supply that normally goes to the brain is cut off and the brain cells that control normal functions are denied the oxygen they need. This can lead to memory and muscle control issues after the stroke.

The complications of a stroke can vary greatly depending on the individual’s past medical history and the severity of the stroke. Some can fully recover from a stroke with just a few visits to the doctor’s office, but some aren’t so lucky. In some cases, a stroke can require hospice care when the patient exhibits the following symptoms.

• Continuing weight loss
• Needing help with routine activities
• Inability to sustain a healthy caloric intake
• Becoming chair or bed bound
• Diminished functional abilities

A stroke can cause a huge lifestyle shift for the patient and their primary caregivers. Thankfully, hospice care will provide comprehensive care for stroke patients at no cost to the patient. This includes available 24/7 care from a carefully staffed medical team and the cost of medical supplies like prescription medications and hospital beds.

At Cura-HPC, our staff has extensive experience helping stroke patients and their families. This can be a very trying time with sudden and dramatic changes, but we are ready to guide your family with top-quality medical care and bereavement support. If you have questions about qualifying for hospice care, give Cura-HPC a call. 

One of the best parts of living in this day and age is that there’s an app for almost everything, including estate planning. These apps can’t replace the expertise of an estate planning lawyer, but they can help you organize your thoughts and make things a little more convenient for your surviving relatives.

Everplans

This app creates one convenient and secure place to store necessary documents for end-of-life planning. Passwords, wills, funeral preferences, and other important documents can all be easily found by your loved ones after you pass away. Everplans also uses a few simple questions to help you create a checklist of all the necessary documents you need for a robust estate plan.

Cake

Similar to filling out an online dating profile, Cake uses a series of simple questions pertaining to post-mortem preferences and you can either swipe left to answer no, or swipe right for yes. Once you’ve completed the questionnaire, Cake will help you create an estate plan that reflects your answers.

SafeBeyond

This app has less to do with the legal side of estate planning, and more to do with the emotional side. With SafeBeyond, you can create written or video messages for your surviving family members that will be automatically delivered at certain dates, events, or locations. For example, a father who knows he will die before his daughter’s wedding can record a video message that she can watch on her wedding day. SafeBeyond can also deliver a final message on social media so you can say goodbye to all your friends.

Again, you’ll need to consult a lawyer to have a strong and thorough estate plan. These apps should only be used as a starting point to get the ball rolling. Although no one likes to think about estate planning, it is vitally important to ensure your final wishes are met and your assets will be bequeathed properly. 

Hospice care is a Medicare benefit that can be provided at four different levels: routine care, continuous care, inpatient care, and respite care. Each of these levels was created to address a different level of need of medical attention.

Continuous care, as you might have guessed by the name, provides 24/7 care for patients. This level of care allows patients to remain in their home as their disease progresses while still meeting their medical needs. With a member of the medical team present at all times, symptoms can be managed better and the patient can experience a better quality of life.

This level of care is available to any hospice patient, if they meet the qualifications. According to Medicare,

“Continuous home care may only be provided during a period of crisis as necessary to maintain an individual at home. A period of crisis is a period in which a patient requires continuous care that is predominantly nursing care to achieve palliation or management of acute medical symptoms.”

A patient can receive continuous care in their home or in a long-term care facility. However, continuous care can not be provided at a hospital or skilled nursing facility.

No matter what level of care you or your loved one needs, Cura-HPC is here to help. We’ve been helping families through the difficulties end-of-life care can present for many years. Our staff is knowledgeable, experienced, and compassionate. If you or your loved one is in need of hospice care, call Cura-HPC and one of our transition specialists will be more than happy to assist you.  

When a patient is facing a terminal illness and curative treatments are no longer working, it’s common for doctors to change the goal of medical care from curing the illness to making the patient as comfortable as possible. This philosophy of care is sometimes called comfort care.

Comfort care also referred to as palliative care, is provided by a hospice care team by focusing on relieving the effects of symptoms. The members of a hospice team will have experience in wound care, medication management, pain management, and other end-of-life issues. To provide more comfort for the patient, comfort care can be provided at home, the hospital, an assisted living center, or where ever the patient lives.

Because not all pain is physical, comfort care also incorporates a spiritual and mental health aspect. A bereavement consoler or chaplain will be part of the care team to help with any non-physical symptoms that may come up. These services are also available to the family of the loved one.

It’s important to note that shifting from curative to comfort care doesn’t mean all life-saving treatments will be automatically stopped. In many cases, a curative treatment will also provide symptom relief and comfort to the patient, so these treatments may continue when comfort care starts.

Making this switch can be a tough decision for families because they feel as if they are giving up on their loved one. However, doctors won’t make this recommendation until all curative treatment options are exhausted, and they feel it’s in the best interest of the patient. Switching to comfort care isn’t giving up, it’s trying to provide the best level of care for the patient as possible.

If you or a loved one are in need of hospice care, call Cura-HPC. One of our transition coordinators will more than happy to talk with you about your options. 

While most deaths are followed by a funeral or memorial service, it’s not entirely uncommon for the deceased to decline a funeral in their will. A funeral serves two purposes – to honor the dead and get closure. So, when the deceased does not want a funeral, families are left wondering how to get the end result of a funeral without actually having a funeral. It’s hard to replace the familiarity of a funeral, but there are four ways you can still honor the dead and get some closure.

Obituary

Spend some time collecting details of your loved one’s life, and write a detailed and loving obituary. This process can be incredibly therapeutic, and seeing your loved one’s picture and story in print can give you closure. You can also rest well knowing you honored their memory well by telling their story and letting others enjoy it.

Carry on Their Hobbies and Projects

If they were passionate about keeping the lawn in pristine condition or tending to the rose bushes, keep these traditions alive. It’s a great way to honor your loved one long after they're gone, and it gives you a tangible way to remember them. Whenever you’re busy working on their project or enjoying their hobby, you can think back to all the good memories of them doing the same.

Donate to a Charity

Contact your loved one’s friends and the rest of the family to take up a donation for your loved one’s favorite charity and make the donation in their name. This allows you to do something they would have really appreciated.

Take a Trip

Find out where their favorite place in the world is and take a family trip there. It could be somewhere they went every year, where a major life event happened, or just their favorite trip they ever took. Once you're there, try to take a walk and reflect on their life. Having this connection will help you hold on the memories while still helping you move on.

Funerals aren’t the only way to get closure, as long as you honor their memory and abide by their last wishes, there’s a lot of different ways to write this chapter of life.  

According to the Humane Society, as many as 500,000 pets end up in a shelter every year because their owners die. While we typically expect to outlive our pets, it doesn’t always happen that way. If you or a loved one is advanced in years and a pet owner, there needs to be a plan in place for the four-legged friend. To make sure pets are taken care of, there are a few options.

Last Will and Testament

Including the pet’s name in the will is a good start, but it’s best to actually name a caregiver to be sure. Pets are treated like any other piece of property when we die, and will be included in any asset division. However, since pets hold more value than a TV, designating someone in the will who is willing to care for the pet is a best practice.

Pet Trust

Setting up a free-standing traditional pet trust will allow pet owners to specify care standards and provide money for the pets. This legal document can be in effect for up to 21 years or until the pet dies. This method is a bit more complicated and will require the help of an attorney.

Pet Protection Agreement

If you know who will be taking care of the pet after you pass, you can create a pet protection agreement. This will clearly name the new guardian, outline care instructions, provide money for care, and allow for a smooth transition. Without something like this in place, it can take months for a judge to rule on where the pet will end up.

Although pets feel like part of the family, they are legally treated as property and need to be accounted for in your final wishes. No matter what method you use, it’s important to make sure your pet will be taken care of.

Summer is one of the busiest travel times of the year. With summer vacations hitting full stride, families are embarking on road trips and flying to all four corners of the map. When a loved one is diagnosed with Alzheimer’s disease, families often feel they need to cancel their upcoming trips. While this might be needed if the disease has progressed far enough, it is possible to travel with a family member who has Alzheimer’s if you take the appropriate precautions.

Use as Many Routines as Possible

Traveling any considerable distance will necessitate breaking a few routines, but try to stick to routine when you can. Change can be strenuous for Alzheimer’s patients, so it might be best to travel to places they’ve been to before. Keep meals at the same time they're used to eating, and pick foods you know they enjoy.

Rest is Important

Vacationing can end up being surprisingly stressful when you try to cram in so many experiences in such a short time. This fast pace can really take its toll on Alzheimer’s patients, so be sure to budget for naps and plenty of rest.

Plan Your Packing

Medications should be the first item on your packing checklist. Plan enough medication to last the entire trip and bring enough for a few extra days just in case. You’ll also want to pack some snacks, and maybe a few puzzle books to keep them entertained for the drive or flight.  

Be Flexible

You never really know what might come up when traveling with a loved one with Alzheimer’s. Give them plenty of attention, and frequently ask how they’re doing. If you’re staying with family or friends, let everyone know about the condition and how they can help.

It’s always best to talk with your loved one’s doctor before taking a trip. Let the doctor know where you’re going and what you’re doing, and ask if they think your loved one is able to travel. 

One of the many benefits of hospice care is the interdisciplinary team of medical professionals who will care for the patient. This team is made up of volunteers, chaplains, social workers, aides, nurses, and medical directors. For this week’s blog, we’ll be taking a closer look at the role of the medical director.

Given the unique nature of the hospice industry, a medical director has slightly different duties and responsibilities than a general practice doctor. To fully understand how hospice works, it’s important to understand what exactly medical directors do.

The main focus of the medical director is to construct and administer the end-of-life care plan for each patient. This means the medical director will meet with each patient, assess their needs, and develop a care plan that meets the needs of each patient. They are then responsible for communicating this plan to the rest of the hospice team and any other caregivers that may be assisting in the care of the patient.

As the needs of the patient change, the medical director will adjust the plan accordingly and inform everyone of the changes. They are also the main resource for the rest of the team and the family in the event a question arises about the care plan or condition of the patient.

Medical directors spend a surprising amount of time talking with families and explaining what’s happening with the patient. This is one of the most important roles medical directors have. It’s imperative families fully understand the treatment plan and can make informed decisions.

On a similar note, medical directors are also tasked with carrying out the patient’s final wishes. If the patient has any advanced directives, like a DNR, it’s the medical director’s job to make sure everyone is aware of these wishes and does not deny them.

Lastly, the medical director is in charge of ensuring all safety and health standards are being met. It’s their job to use unbiased data to ensure the care provided is of the highest level and to check for any areas that need improvement. 

Having to tell a child you’re terminally ill isn’t something that’s typically covered in the parenting handbook. It’s hard for children to learn their parents are dying at any age, but as a young child, it can be devastating. This will be a difficult conversation to have no matter how you go about it, but there are a few things to keep in mind that can make it a little easier.

Be the One to Tell Them- This isn’t something anyone looks forward to doing, but don’t put it off so long that they overhear the news from someone else. It’s important they hear this from you in a setting that allows you to answer whatever questions they may have.

Let Them Help- As you’re going through the various treatments and procedures, try to include them in your care. Let them get you a glass of water or a pair of slippers when you need it. Finding age-appropriate jobs for them to do will help them feel involved.

Be Clear- When you break the news, it’s okay to be direct with your child and let them know the name of the disease and what the expected side effects are. This will help prepare them for the coming months and gives them more clarity.

Create a Support System- Your child will need a support system of people who they can talk to about what they’re feeling. Let their friends, teachers, and other family members know what’s happening so they can be there to offer care and support.

Keep Their Schedule- This news will come as a huge shock to them, and one way to help them cope is to maintain their schedule as much as possible. Although you might not be able to take them to all their activities, ask friends and family if they can help take care of chauffeuring them around.

With the 4th of July now behind us, we’re well into the summer months that are sure to be sweltering. Now that the heat is on, we need to pay close attention to the senior community as they are very susceptible to the effects of heat. If you have a loved one in their senior years, here are four tips you can follow to keep them safe in the summer.

Stay Hydrated

As we age, our sense of thirst is often diminished. This means seniors can easily forget to drink enough water, and by the time they remember to drink some water they can already be dangerously dehydrated. This goes double for seniors with dementia. To ensure proper hydration, make sure caregivers are regularly providing water and monitoring hydration levels.

Stay Connected

If your loved one lives alone, without visits from caregivers, it’s best to give them a call at least once a day. See how they’re doing and ask how much water they’ve had to drink. You can rest assured they’ll appreciate the daily communication and it’s a great way for you to check up on them to see if they need anything.

Stay Cool

The summer heat can take a toll on seniors, but keeping them cooped up in their homes all day can also have serious negative health effects. It’s important for seniors to maintain an active social life during the summer, but proper planning is needed. Avoid running outdoor errands during the hottest parts of the day and schedule trips to air conditioned locations throughout the day.

Stay Aware

If all else fails, you need to be aware of the signs of heat stroke. Not sweating in hot settings, confusion, nausea, headaches, fatigue, fever, and rapid pulse are all signs your loved one might be experiencing a heat stroke. If this happens, seek immediate medical attention. 

Dealing with grief is a skill we all must learn at some point in our lives. Whether it’s the death of a friend, a family member, or helping a friend through a death, understanding how to deal with grief for the first time can be a hard journey to walk. Children who go through grief-inducing experiences, particularly those who do so at a young age, need guidance to help navigate the emotions they may be feeling for the first time. You don’t have to be a professional counselor to help children through grief, so here are some tips to help you help them.

Death is Normal- Try to be proactive and teach children about death before they experience the death of a loved one. Point to examples of death in nature, like dying plants or animals, as less emotional examples of death. This allows children to grasp the concept of death without the associated grief. Sometimes parents avoid talking about death with their children in an effort to shield them from harsh realities, but children need to understand death is a normal part of life. 

Be Ready for Questions- It’s not uncommon for children to have a lot of questions about death when they hear about it for the first time, so be ready. If you don’t know the answer to a question, it’s okay to say so. Let them know you’re struggling with this too.

Honesty- Sometimes analogies and metaphors are helpful, but this might not be the best time for such tools. Don’t be afraid to be straightforward about death. Using terms like, “they went to sleep” might confuse children about what death is and how it works.

Grieve with Them- Don’t feel the need to grieve behind closed doors. Children need to see how people grieve and what’s okay to do in these times. It’s okay for your kids to see you cry and be emotional. This lets them know it’s okay to feel and experience the emotions that are flooding in.

Grieving with children, like grieving with anyone, is a learning process. Don’t feel pressure to get it right the first time or be perfect. The more important thing to do is let them know you’re here for them. Not every child will grieve the same way. Be adaptive and flexible, so you can meet their needs. 

When going through a loss one of the hardest things to do can be letting friends and family know what you need. Although friends can be quick to offer help, knowing how to respond to their offers isn’t always straightforward. One reason for this difficulty is that it’s often just hard to figure out what you need, let alone communicate it to others. Despite the difficulties, letting people know what you need can really improve the grieving process and help you get through this time.

Just Talk

Talking is often the best way to overcome this hurdle. It could be about what you’re feeling or it could be about the weather. Ideally you’ll eventually be able to work up to talking about your grief, but starting with small talk is perfectly fine. These conversations can be incredibly therapeutic and can help you assess and better understand your needs.

Write it Down

If you can’t handle talking it out, try writing it down. Start a journal about what you’re feeling and how it’s affecting you. Be introspective and once you feel comfortable enough, share some of your journal entries with close friends or family.

This Isn’t Working

It’s okay to, politely, let people know if what they’re doing isn’t helping. Your friends want to help you, but it’s most likely going to be a learning process for everyone. So if they try to help in a way that just isn’t really working, don’t be afraid to say so. A word of caution though. If you feel like changing course because you feel like you’re “too big of a burden” for your friends, this is not a good excuse. Don’t ever feel like your grief is causing others to suffer, your friends are there to help.

Different is Okay

When it comes to family, you might feel pressure to grieve or cope in the same ways the rest of the family does. However, family traditions don’t apply to grief. Just because they like to keep busy to take their minds off it, doesn’t mean you have to. Have an honest conversation with the rest of your family and work together to make sure everyone is getting the support they need.

Dealing with the death of a family member is hard enough when the deceased prepared a crystal-clear will, but when there’s no will to be found it can cause some serious issues. Since recent studies have estimated more than 60% of Americans don’t have a will, this situation is one you might have to deal with one day. Dying without a will doesn’t automatically doom the family to chaos and feuding, if it’s handled correctly.

It’s hard to be right

Just because the deceased told you they wanted to give you some item or money after they pass doesn’t mean they didn’t tell another family member contradictory information at a later date. Anytime you mention a statement you recall them saying, do so with grace, and don’t be surprised if another family member remembers something different.

Include everyone

During the deliberation process, it’s common for a few pack leaders to rise up. While this can ensure the ball keeps moving, you don’t want to exclude people from the process. People are always more likely to accept a decision they don’t agree with if they feel their voice was heard from the start of the process.

Define “fair”

One word that will get thrown around a lot in these situations is, “fair.” You’ll hear statements like, that’s not fair, let’s all try to be fair, or that seems fair to me. The problem is that not everyone has the same idea of what fair means. Some might define it as trying to equally divide everything based on monetary value, others will want to factor in sentimental value, and others might want to divide assets on a needs basis. Get everyone on the same page and things will go much smoother.

Call a Professional

Dealing with this kind of problem isn’t something most people have ever tried to do. Thankfully there are professionals who do this for a living. If things get to a point where you feel the family can’t handle it, call a mediator or estate planning attorney. Either one will be able to guide you through the process and offer some sage advice.

One of the most amazing aspects of hospice care is that patients almost never have to pay a dime for care. In the vast majority of cases, 100% of the costs associated with hospice care will be covered by Medicare through the Medicare Hospice Benefit. This includes the costs of the patient’s interdisciplinary medical team, medication, bereavement support, inpatient care, home visits, and medical equipment.

Other Forms of Payment

In some cases, a patient might not qualify for Medicare coverage or prefer to use another method of payment. Although these cases are extremely rare, if this situation ever arises the following options can be used.

Medicaid- In most states, Medicaid will also provide hospice coverage for patients who need it.

Private Insurance- Most private insurance plans and HMOs will also include a hospice care provision for those who do not qualify for Medicare or Medicaid.

Veterans’ Benefits- The Veteran’s Health Administration can also provide hospice coverage for those who qualify.

Out of Pocket- If a patient doesn’t qualify for Medicare, Medicaid, private insurance, or VA coverage, they can always pay for hospice care out of pocket. Again, this is incredibly rare and only accounts for less than 1% of hospice patients in a given year.

No one should have to deal with medical bills while going through end of life care, which is why hospice is such a great option. If you’re looking for a hospice care provider and have questions about payments or anything else, call Cura-HPC today.

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.  

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. 

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. 

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.  

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!

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.

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).

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. 

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.

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. 

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. 

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. 

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. 

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. 

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.

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. 

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. 

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. 

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. 

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. 

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.  

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.  

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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.  

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. 

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. 

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. 

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. 

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. 

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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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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. 

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.