What is Hospice?

Hospice is not a place. It is a medical specialty for terminally ill patients — regardless of their specific disease — that can be delivered in a hospital, a nursing home, a hospice facility, the patient’s home or any other place the patient lives. Hospice is available to people of all ages, including children. The purpose of hospice is to focus on care at the end of a patient’s life. But it is more than that. Hospice is a state of mind. It is a turning away from aggressive medical measures designed to prolong life when those procedures are invasive and no longer productive. It is a recognition that the end of life is approaching.

When dealing with a terminal disease or situation, it’s easy to get caught up in medical details and forget that a patient also has social and emotional needs. Hospice is a holistic approach that cares for the whole patient — physically, emotionally and spiritually. The philosophy behind the hospice program is based on the premise that everyone has a right to die with dignity in as much comfort as possible, as alert as possible, and with an opportunity for personal growth and for the healing of personal relationships. Because care is centered on enhancing the quality of life even when the end is in sight, hospice is really all about living.

Doctors and nurses who practice within hospice are trained to focus on the patient, not on the disease. Specially trained for end-of-life care and experts in pain management, their aim is to create a comfort zone for patients without inducing the drug-related fog that robs patients of their will and senses. Entering hospice doesn’t mean a patient must give up his or her regular doctor; hospice doctors work with the patient’s attending physician to customize care.

Hospice never hastens death, but it eases the journey for both patient and caregivers with an emphasis on quality of life over quantity of life. The hospice team — which includes doctors, nurses, aides, social workers, spiritual and bereavement counselors, and volunteers — all trained in end-of-life care, cradles patients and families in its nurturing embrace. It allows patients to focus not on dying, but on the things they find meaningful in their remaining days. That may mean attending that long-postponed family reunion, finishing a pet project or just talking with friends. It may mean attending to end- of-life tasks, such as creating a medical directive or signing a will. It may mean reminiscing about good times and tough times with a hospice volunteer in a “life review.” At a time of life’s greatest transition, hospice services can bring families closer together.

Caregivers are as much a part of the end-of-life process as patients, and oftentimes their needs and stresses are ignored. Families often find themselves exhausted and emotionally spent as a result of their responsibilities. By providing a support system for caregivers, hospice can bring relief. Volunteers can ease caregiving responsibilities by providing respite care, running errands or simply offering the patient companionship while caregivers take some time for them- selves. Aides are available to provide personal care to patients and can even attend to household duties. Hospice even provides those who are left behind with bereavement counseling and services during that first difficult year when all those birthdays, anniversaries and holidays can seem so empty.

Once a patient enters a hospice program, Medicare covers nearly all of the costs of medications and supplies. Hospice can even provide medical equipment, such as a hospital bed, walker or wheelchair, to allow patients to remain comfortably at home. For families struggling with the costs of medical care, hospice provides its own financial solutions. The best part is that hospice care is designed to meet each individual patient’s needs. There is no set formula, no agenda. Services are made available, and patients and caregivers can choose as much or as little as they desire.

Choosing hospice does not mean giving up. Some patients live far beyond six months, and miracles do happen. Hospice actually represents hope: it’s a time to find love and forgiveness and reconciliation with the past. Dignity and peace at the end of life are precious gifts to which everyone is entitled. Hospice is there to ensure that no one passes away alone or uncared-for, and that families are supported and comforted in their grief.

Common Diagnoses

Common Diagnoses are, but not limited to the following:

  • Cancer

  • Lung Disease

  • Stroke

  • Renal Disease

  • AIDS/HIV

  • Alzheimer’s Disease

  • Heart Disease

  • Liver Disease

  • Parkinson’s Disease

  • Multiple Sclerosis

 
 

Defining Cancer

Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems.

Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start – for example, cancer that begins in the colon is called colon cancer; cancer that begins in melanocytes of the skin is called melanoma.

Cancer types can be grouped into broader categories. The main categories of cancer include:

  • Carcinoma – cancer that begins in the skin or in tissues that line or cover internal organs. There are a number of subtypes of carcinoma, including adenocarcinomabasal cell carcinoma,squamous cell carcinoma, and transitional cell carcinoma.

  • Sarcoma – cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

  • Leukemia – cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.

  • Lymphoma and myeloma – cancers that begin in the cells of the immune system.

  • Central nervous system cancers – cancers that begin in the tissues of the brain and spinal cord. 

Origins of Cancer

All cancers begin in cells, the body’s basic unit of life. To understand cancer, it’s helpful to know what happens when normal cells become cancer cells.

The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.

However, sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them. The extra cells may form a mass of tissue called a tumor.

For more information about cancer visit: www.cancer.gov

 

Alzheimer's Disease

What is Alzheimer's Disease?

Alzheimer’s disease is a type of dementia that causes problems with memory, thinking, and behavior. It is a progressive disease. This means it gets worse over time and continues to progress for the rest of a person’s life. That’s why it is important to recognize the symptoms of Alzheimer’s disease sooner rather than later and discuss treatment options with a healthcare provider.

How does Alzheimer's Disease progress?

In the early stages of Alzheimer’s disease, memory loss may be mild. Symptoms in this stage may include getting confused in familiar places and taking longer than usual to complete normal daily tasks. The disease progresses at different rates in different people. Generally, patients with moderate Alzheimer’s disease experience the fastest rate of decline. As a caregiver, you know the person you’re caring for better than anyone. Tell the healthcare provider if you notice any changes in symptoms. As the disease progresses, the healthcare provider might talk about the symptoms of Alzheimer’s disease as occurring in moderate and severe stages.

What are the symptoms of the moderate and severe stages of Alzheimer’s disease?

As symptoms progress – or worsen – your loved one will move through different stages of the disease. The table below provides examples of the symptoms at the moderate and severe stages.

Moderate Stage

Signs and symptoms of moderate Alzheimer’s disease may include:

  • Increased memory loss and confusion

  • Problems recognizing family and friends

  • Continuously repeating stories, favorite wants, or motions

  • Difficulty doing things that have multiple steps, like getting dressed

  • Lack of concern for hygiene and appearance

Severe Stage

Signs and symptoms of severe Alzheimer’s disease may include:

  • Inability to recognize oneself or family

  • Inability to communicate

  • Lack of control over bowel and bladder

  • Groaning, moaning, or grunting

  • Needing help with all activities of daily living

 

Stroke

A stroke or “brain attack” occurs when a blood clot blocks an artery (a blood vessel that carries blood from the heart to the body) or a blood vessel (a tube through which the blood moves through the body) breaks, interrupting blood flow to an area of the brain.  When either of these things happen, brain cells begin to die and brain damage occurs.

When brain cells die during a stroke, abilities controlled by that area of the brain are lost.  These abilities include speech, movement and memory.  How a stroke patient is affected depends on where the stroke occurs in the brain and how much the brain is damaged.

For example, someone who has a small stroke may experience only minor problems such as weakness of an arm or leg.  People who have larger strokes may be paralyzed on one side or lose their ability to speak.  Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability.

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