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.