Archives March 2022

One of the greatest gifts in life can be raising a child. It’s not life’s only great gift, but those who are blessed to be a parent find that it can be rewarding yet difficult. The difficulty is often in trying to control an uncontrollable situation. A situation like a baby. You can’t tell why they are crying, but you have to figure it out and make it better. A situation like teaching self-control to a 5-year-old. He just can’t quite sit still, but he is going to school for the first time. Situations like teaching a 15-year-old how to drive. You hope that everything turns out well, all the while your fingernails dig into the armrest of your seat. From the moment you are born, until the moment you leave this earth; life is all about controlling often chaotic situations.

One of the greatest gifts in life can be raising a child. It’s not life’s only great gift, but those who are blessed to be a parent find that it can be rewarding yet difficult. The difficulty is often in trying to control an uncontrollable situation. A situation like a baby. You can’t tell why they are crying, but you have to figure it out and make it better. A situation like teaching self-control to a 5-year-old. He just can’t quite sit still, but he is going to school for the first time. Situations like teaching a 15-year-old how to drive. You hope that everything turns out well, all the while your fingernails dig into the armrest of your seat. From the moment you are born, until the moment you leave this earth; life is all about controlling often chaotic situations.

Each year during the month of October there is a great emphasis placed on cancer awareness, especially breast cancer. What a challenging disease cancer is. The moment you hear a diagnosis of cancer, everything changes. Your hopes can seem more hopeless, your goals are now focused in a different direction, and your fears can become more prevalent. It is almost as if cancer begins to eat away at this control that you have been building throughout your entire life.

The fact is: Cancer is difficult, but it should never beat you. You control the rules of your life, and should never let cancer define who you are. Take back control and fight like never before. Fight the disease and seek a cure when available. Fight to keep your goals moving forward. Fight the feelings of fear that begin to creep into your mind. Fight cancer with all that you have. Even when you think every bit of effort has been exhausted, you fight. Even when doctors say there is nothing left to try, you fight.

The question is what are you fighting for? Sometimes we are fighting for a cure, but oftentimes we are fighting for control. Control to take back our lives and live whatever time we have left the way we choose. Live in the place you call home. Live surrounded by the people you know and love, not in a hospital surrounded by strangers. Live without the effects of treatments, and fight for quality in your life.

Hospice is a specialized form of healthcare that fights alongside you and your family when a terminal illness thinks that it has won. We help you take back control and manage symptoms. We help you fulfill any wishes that are still on your list. We make sure that no one is alone, afraid or in pain. We provide a team of people that will support you in your fight – as you take back control of your life!

If you or a loved one need someone to fight alongside you, please call us today. We believe that you should finish this race well, and we will always do whatever it takes when it matters most to get you there.

We make decisions every day of our lives.  Some are big and life-changing, while others are less impactful.  Should I have that second brownie, or should I not?  Should I wear blue or green today?  Should I quit my job, or should I stay?  While the magnitude of these questions obviously carry wildly different significance, the degree to which we struggle to determine an answer is usually oddly similar.  The reason – it is hard to know what to do most of the time.  It is hard to know for sure what the right answer is.  It is always the right decision to take the second brownie. 

One question most all of us will face at some point is what to do when facing a life-limiting illness?  The good news is, you have options and it is your right to choose.  Continuing aggressive treatments for your illness is one avenue that you can take.  For example, a feeding tube to supplement nutrition and external ventilation can be utilized.  Also, chemotherapy or other aggressive pharmaceutical interventions may be used.  Another route may be palliative care.  Palliative care is a combination of continuing certain aggressive treatments, while treating the symptoms that go along with end-of-life scenarios.  When terminal illnesses progress to end-stage levels, hospice becomes the best alternative.  

While no one can give you the perfect answer for your end-of-life situation, there are definite criteria that can point towards knowing if it is time to seek a hospice consultation. 

Here are some of the most common hospice diagnoses and the indications that hospice is appropriate: 

Cancer

• Curative treatment unlikely to improve quality or length of life
• Metastasis to multiple sites

Heart Failure

• Chest pain and/or shortness of breath with and without activity
• Taking multiple cardiac medications
• Patient and/or physician believe heart surgery is not a preferred option

Chronic Obstructive Pulmonary Disease (COPD)

• Shortness of breath at rest and with any activity
• Recurring respiratory infections
• Using multiple inhalers with poor response

Dementia

• Speaks few intelligible words
• Needs help to sit up
• Unable to walk without assistance

Stroke/CVA

• Difficulty swallowing, unable to take in adequate nutrition
• No feeding tube (current or planned)

Liver Failure

• Ascites despite use of diuretics
• Serum albumin 1.5

Renal Failure

• Considering stopping dialysis
• Serum creatinine >8.0 (>6.0 for diabetics)

HIV

• CD4+ count 100,000
• Secondary conditions (Kaposi’s sarcoma, pneumocystis pneumonia, fungal infections, etc.)

Amyotrophic Lateral Sclerosis (ALS)

• Barely intelligible speech
• Significant shortness of breath
• Difficulty swallowing accompanied by rapid weight loss
• No feeding tube or ventilator (current or planned)

You have to decide the best answer for your situation, but it is good to know that you have options.  We find that people usually tell us that they wish they knew about hospice sooner.  If you or a loved one are facing a life-limiting illness, give us a call and let us help you navigate your options when it matters most. 

The reality of time is that it is limited. We experience this truth all throughout life. In elementary school we often realize how limited our time on the playground is. As parents we realize how quickly our kids grow up. As individuals we eventually find that life is fleeting, and it is the quality of the life we live that is most important.

At some point everyone, or one of our loved ones, will be faced with a life-limiting illness. We will be faced with the reality of the limits of time. While this can be difficult to deal with, there are ways to ease the stresses of this time.

In an article published in 2014, researchers sought to find out what were the critical components of a “Good Death.” At the conclusion of this research, it was found that clinically relevant factors, including hospice, were associated with good death. The clinically relevant factors of a good death, as described by families participating in the research, are below:

• Hospice was involved in care
• Patient/Family did not receive conflicting information
• Symptoms and Pain were managed
• Stress/Anxiety was managed
• Wishes were followed/granted
• Attention was given to non-medical issues as well
• Excellent provider expertise
• Excellent provider compassion

The reason hospice care is so critical, is that it is uniquely focused on each of these clinical factors. These hospice care teams have a specialized experience in managing the symptoms of end-of-life, and also included social workers, bereavement works and chaplains that manage non-medical issues. The longer an individual is able to spend on hospice care, the better the outcomes experienced. Hospice should begin as soon as a life expectancy of 6-months or less is determined.

Not only is the time surrounding end-of-life difficult for family and loved ones, it is also difficult for many care providers. Most physicians and traditional care teams are focused on curative efforts rather than palliative. That is why it is important to partner your traditional medical team with a hospice team who has expertise in end-of-life care.

Don’t wait to have the conversation, begin to plan your future today. After all — time is limited, this is the reality that we all must face.