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.  

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. 

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.