Getting Through The Holidays While Coping With Grief

Holiday season is traditionally a happy time of year. We gather with family and friends and enjoy fun and fellowship. But for those who have suffered the death of a loved one, the holidays can be difficult.

What can a person who is grieving a loss do to make it through the holidays?

Dr. Alan Wolfelt has several suggestions to help you cope with feelings of sadness during what is generally a festive time of year. Dr. Wolfelt is a grief specialist.

• Talk about your grief. Seek the company of a friend or relative who will listen and allow you to share your feelings.
• Do what is right for you. If family or friends have made special plans for you, but you don’t feel comfortable with those plans, speak up. Let them know your wishes about what you would like to do.
• Talk about the person who has died. Mention him or her by name. Talking about the loved one you have lost and sharing memories—both good and bad—can lead to laughter or tears. Remember that it is okay to laugh. And okay to cry.
• Don’t do too much. Grief and sadness can affect your energy levels. If your body is telling you to slow down, listen.
• If certain family holiday traditions are likely to make you uncomfortable, it is your choice whether or not to participate. Similarly, if you wish to begin a new family tradition, let your feelings be known. Anticipate what might happen at family gatherings rather than being caught off guard.

This quote from Dr. Wolfelt gets to the heart of the matter. “As you approach the holidays, remember: grief is both a necessity and a privilege. It comes as a result of giving and receiving love. Don’t let anyone take your grief away. Love yourself. Be patient with yourself. And allow yourself to be surrounded by loving, caring people.”

For questions about grief counseling or any other aspects of hospice care, please call Hope Hospice at 314-984-9800. Hope Hospice serves patients and families in metro St. Louis, Missouri.

(photo credit: http://www.flickr.com/photos/94828981@N08/9149741897, http://photopin.com, https://creativecommons.org/licenses/by-nc/2.0/)

Sarah’s Interview with KEZK

Our community liaison Sarah Bilbrey was interviewed this week by Greg Hewitt, morning host at KEZK (102.5FM) in St. Louis. To listen to their conversation about National Hospice Month and hospice care in St. Louis, please click on the link below.

Hospice Facts and Figures

The latest report from the National Hospice and Palliative Care Organization (NHPNO) offers important and meaningful statistics regarding hospice care in the United States. The most recent year for which full stats were available is 2013.

The average time that a patient was on hospice in 2013 is 72.6 days.

Among hospice patients in 2013, 34.5% were on hospice 7 days or less before death occurred. 14.3% were on hospice for 8-14 days. Another 12.7% were on hospice for 15-29 days. This means 61.5% received care for less than a month. (We presume that many of that 61.5% might have qualified for hospice sooner and received a more complete assortment of hospice services.)

66.6% of hospice patients were at home in 2013 when they passed away. That number is composed of 41.7% who were in private residences. 24.9% were in nursing homes or other residential facilities.

Approximately 84% of hospice patients in 2013 were age 65 or older. 41.2% were 85 or older.

Of those admitted to hospice in 2013, 36.5% had a cancer diagnosis. The majority, 63.5%, had non-cancer diagnoses. Those included dementia (15.2%), heart disease (13.4) and lung disease (9.9%).

Family evaluations of hospice care after their family member’s death included this positive result: 73.5% of those surveyed rated their family member’s care “excellent.”

According to NHCPO estimates, the number of hospice volunteers serving patients topped 355,000 during 2013. They provided approximately 16 million hours of volunteer service.

The Medicare hospice benefit covered 87.7% of hospice patients in the U.S. during 2013. Medicaid, managed care and private insurance covered 10.0%.

These cold, hard stats are useful but they cannot describe the warmth and compassion that most hospice employees and volunteers have for their patients and families. The numbers are impressive, but it is important to remember that, ultimately, hospice care is about quality rather than quantity.

For information about hospice care in metro St. Louis, please call Hope Hospice at 314-984-9800.

Hospice? Upbeat?

Is it possible that hospice care can be administered with an upbeat attitude? With smiles and laughter? Can the period when a patient is on hospice anticipating end-of-life be a time that also has positive experiences? At Hope Hospice, we believe the answers to these questions are, generally speaking, yes.

Certainly we take our work seriously. We know that an approaching passing can engender great stress for patients and families. We respect the fact that intense feelings of sadness have occurred and will continue to occur.

Of course, circumstances vary from patient to patient and family to family, but we work to balance those unhappy moods with warm, pleasant greetings and visits that, while acknowledging the reality of the situation, bring comfort to our patients.

We know that each day is a new experience for all of us. Life’s small pleasures are to be savored: a song, a story, a joke or just a chat about the simplest of things. If the opportunity exists to brighten a patient’s day, even just a little bit, we do what we can. If we can make a patient smile, that’s a positive experience for all concerned.

For a hospice patient, often one particular day may be better than others. Taking advantage of those good days and enjoying small pleasures is something we encourage. Knowing what lies ahead should not prevent patients and caregivers from sharing those brighter moments as they occur.

For information about hospice care in metro St. Louis, call us at Hope Hospice at 314-984-9800. We are happy to answer any questions you may have about hospice.

(photo credit: http://www.flickr.com/photos/26224875@N02/3974382336, http://photopin.com, https://creativecommons.org/licenses/by/2.0/)

The D-Word (Don’t Be Afraid To Say It)

Death. It is a reality we all will experience.

But when a person faces a serious medical condition, we may be reluctant to speak the words “death” and “dying.”

Dr. Edward Bruera of the MD Anderson Cancer Center in Houston says that one reason families don’t want to talk about death is the fear that doing so will destroy a patient’s hopes of surviving. (His thoughts were shared recently via the Houston Chronicle.)

Dr. Bruera suggests that we should think of end-of-life planning as “smart decision making.” When you buy a car, you purchase insurance. You wear a seat belt. You lock the car when you park it. You hope for the best. But if things don’t go well, you have prepared for the worst.

“When we normalize [talk about dying],” Bruera said, “and realize that we all need to make some preparations and plans, it lifts a weight from the shoulders of patients and families. Most of the time, patients find these conversations reassuring, and that’s gratifying to us.”

Have you spoken to your spouse, your children, your parents or other loved ones about end-of-life care? Do you want to die at home surrounded by loved ones? Would you prefer that medical teams do everything possible to keep you alive?

Have you selected an individual to speak for you and make end-of-life decisions for you if you are unable to make them? Have you made your end-of-life care wishes known through a living will?

This Thursday, April 16, is National Healthcare Decisions Day. It’s a day whose purpose is to encourage Americans to make their wishes known via advance directives (living wills and medical power of attorney designations).

Hope Hospice team members will be at two area Walgreen’s locations on Thursday, April 16, 11:30 a.m. to 1:00 p.m. to answer questions about advance directives and to share forms and other printed material with visitors. Those Walgreen’s locations are 13992 Manchester in west St. Louis county and at 519 South Truman Boulevard in Festus.

(photo credit: http://www.flickr.com/photos/50965924@N00/16262956505 via http://photopin.com, https://creativecommons.org/licenses/by/2.0/)

 

 

 

Make Your Choices Known On April 16

 

National Healthcare Decisions Day is Thursday, April 16, a day to think about advance planning for your life and the lives of your loved ones. But wait, you say, everybody’s healthy and nobody’s facing any sort of health crisis. Great! That makes now a perfect time to think about all those relevant questions.

If you haven’t personally experienced the pressure of making a difficult decision regarding a family member’s treatment, you may know someone who has. Family discussions can be marked by heated comments and can lead to personal upset and family discord.

You can spare your family this painful experience by deciding now, when your mind is clear, the types of actions you would prefer to be taken on your behalf. One form of advance directive is a living will in which a person specifies what actions should be taken if they are no longer able to make decisions for themselves.

Another form of advance directive allows you to assign a “durable power of attorney” designation to your spouse, partner, child or other family member or friend. This authorizes another person to make decisions on your behalf if you are incapacitated.

By issuing advance directives, you have the ability to guide healthcare providers and loved ones regarding what you want. Advance directives give you the ability to spell out the types of healthcare you want and do not want and to name an “agent” to speak for you if you cannot speak for yourself.

The living will is to be used only if a person has become unable to give consent or refusal. A living will can be very specific or very general. A living will that you establish now can be updated and revised at a later date, if you choose.

National Healthcare Decisions Day was begun by an attorney in Richmond, Virginia in 2008. In metro St. Louis, several healthcare organizations and elder law firms will participate this year. For information click HERE.

Hope Hospice will host informational events for National Healthcare Decisions Day on April 16 at two area Walgreen’s pharmacy locations: 13992 Manchester in West County and 519 S. Truman Boulevard in Festus. Hope Hospice team members will be at each location from 11:30 a.m. until 1:00 p.m., answering questions about advance directives and providing printed information and forms.

The Missouri Attorney General’s website has forms and guidance for making these important decisions. Go online to ago.mo.gov, click on “publications” and “life choices” to download these materials. In Illinois, go to dph.illinois.gov and click on “forms and publications” for materials.

As the video at the top of this post (which also appears on the National Healthcare Decisions Day website) asks, “Who will speak for you when you can’t speak for yourself?” The video also instructs, “Make sure your voice is heard.” Make those decisions now. You may not be able to make them later.

For answers to your questions about advance directives or hospice care, please call Hope Hospice at 314-984-9800.

 

 

Why Hospice?

1. Because your loved one, even if he or she is bedridden, would prefer to be at home instead of in a hospital.
2. Because the top priority of hospice care is patient comfort including relief from pain.
3. Because going on hospice does not mean giving up.
4. Because hospice focuses on the quality of a patient’s remaining time, instead of continuing treatments to prolong life.
5. Because hospice team members guide family members and/or private care personnel on proper caregiving for each individual patient.
6. Because hospice patients, on average, live longer than those who are not on hospice. This result has been repeated by numerous studies.
7. Because hospice care includes necessary medical equipment such as oxygen, hospital beds, wheelchairs, etc.
8. Because spiritual and emotion support is available to the patient and family members.
9. Because hospice is fully covered by Medicare, Medicaid and most insurance plans.
10. Because hospice is not just for the last few days of a person’s life.
11. Because hospice is not just for cancer patients. While hospice provides care for many cancer patients, people with other life-limiting conditions such as Alzheimer’s, renal failure, congestive heart failure may also be eligible for hospice.
12. Because hospice care is delivered with compassion.

For information about hospice care in metro St. Louis, please call Hope Hospice at 314-984-9800.

(photo credit:  http://www.flickr.com/photos/44124395312@N01/442372023, via http://photopin.com,  https://creativecommons.org/licenses/by-sa/2.0/)

Hope Hospice Angels? Not Exactly, But…

Hospice personnel have frequently been referred to as “angels.”

By certain definitions, that’s an accurate term. “A person having qualities generally attributed to an angel, (such) as… kindliness.” “A person who…acts as if sent by God.” “Someone who is very good or kind.” “A person of exemplary conduct or virtue.”

Numerous survivors of hospice patients have written letters to us at Hope Hospice describing our staff members as angels. We are not the only hospice to receive such high praise. Some hospices around the U.S. and the world have even gone so far as to include the word “angel” in their hospice name.

While angels depicted on TV and in movies (such as Clarence in It’s A Wonderful Life and Jonathan Smith on Highway To Heaven) have a direct line to heaven and God, our team members cannot make that claim. But our employees and volunteers have served patients and family members with similar dedication and determination to do things the right way. When circumstances dictate a need, our team members go above and beyond to make sure things are taken care of, in the patient’s best interests.

The country music group Alabama sang a song called Angels Among Us, describing angel-like behavior by fellow humans along the path of life. But the chorus speaks of angels sent from “somewhere up above.” About those angels, they sing: “They come to you and me, in our darkest hours… To show us how to live, to teach us how to give, to guide us with the light of love.”

Our Hope Hospice “angels” are not from somewhere up above. They are all mortal, from here on earth. But the level of compassion and care that’s delivered daily to our patients and their family members is exceptional. And for that we are proud.

For information about hospice care in metro St. Louis, please call us at Hope Hospice at any time at 314-984-9800

(photo credit: http://www.flickr.com/photos/73299047@N06/12232278415,  http://photopin.com,  https://creativecommons.org/licenses/by-nd/2.0/)

 

 

 

 

 

 

 

 

 

When The Family Has Disagreements About Hospice

When a doctor tells a family member that an illness is terminal, there may be disagreement among other family members about the next steps to take.

When dad has been told that death is just a few months away, sons and daughters may want dad to go on hospice while mom may want to continue aggressive treatment. (Or those sides of the argument may be reversed.)

Frequently, these disagreements occur because of a lack of familiarity with hospice. The concept is still relatively new, just a few decades old in the U.S. Even those in their 70s and 80s who’ve had friends on hospice may not know the full scope of hospice care and may have fallen prey to hospice misconceptions.

The most important things to know are: Hospice care does not speed up the dying process. Hospice is focused on patient comfort and pain relief. If a patient and/or caregivers want to rescind the decision to accept hospice care, it can be easily done.

It can be hard for any family member to face up to the reality that mom, dad, husband, wife or other family member will soon be gone. When a patient signs on for hospice care, there is an implied acknowledgement that life’s finish line is within view.

Convincing others who are providing input into the decision that your position (either for or against hospice care) is the correct choice can be difficult. A visit with a hospice representative can address most of your concerns and may reveal to all concerned that hospice is the proper choice. Or maybe not, for now.

We at Hope Hospice welcome the opportunity to share our story with all who will listen. If you have any questions about hospice care in St. Louis, call Hope Hospice at 314-984-9800.

 

 

 

 

 

 

 

 

 

How Much Time Do I Have Left?

“How much time do I have left?”

That’s often the reply when a doctor says to a patient that treatments are no longer working and that a patient should consider hospice.

But maybe the question should be: “How can I make sure that the time I have left is best utilized?”

It is impossible to say exactly how much time a person has left, so the best estimate is an educated guess. Even with cancers that progress in patterns that are familiar to physicians, no one can say for sure how long a patient has left.

For a patient and his or her caregivers (and others who are close to the patient), the choices are continued (often futile) efforts to confront the terminal condition or the pursuit of meaningful life experiences during one’s remaining time.

If you search the internet for personal hospice stories, you will read of sons and daughters who tell of a parent’s final days/weeks/months and a different, special kind of closeness enjoyed with mom or dad. You will learn of survivors who were grateful for the quality experiences with their loved ones before their passings. And you will learn the value of being able to say goodbye—for the patient and the survivors.

If a patient seeks hospice care in time (there’s that word time again!), he or she may have opportunities to visit with friends and family and have conversations that may not be possible if the patient is in a hospital ICU.

“How much time do I have left?” At age 40, we might think we have another 40-50 years. At age 65, we may figure on living another 25 years or so. At age 90, we know time is shorter, but even then we may presume that death is still down the road.

When a terminal diagnosis is delivered, things become more urgent. Yes, the number of days remaining is important to consider. But the quality of those remaining days should also be considered.

For information about hospice care in metro St. Louis, please call Hope Hospice at 314-984-9800.

(photo credit: http://www.flickr.com/photos/30227069@N06/4337496170, http://photopin.com, https://creativecommons.org/licenses/by-nd/2.0/)