Pick Up A Guide

If you or a loved one were facing a terminal illness, would you know where to turn for information about end-of-life care?Every year, half of the American population will be touched by the death of a friend, family member or colleague. Hospice providers across the country are united in urging all adults, regardless of age or circumstance, to learn more about end-of-life care options that can transform dying into the final act of living well.There are four general questions that should be explored before one is touched by the unsettling reality of a terminal prognosis, explains Ann Klein, RN, VITAS patient care administrator in New Jersey North. They are: 1. How will pain be managed? 2. If the patient prefers to remain at home, what kind of assistance and in-home care will be available? 3. What role can family members have in patient care? 4. How will the spiritual and emotional support necessary for quality end-of-life care be administered?Hospice is an end-of-life care option that answers all four questions, Klein says. Tailored to the needs of each patient and family, hospice provides care to patients diagnosed with a terminal illness. It includes expert pain management, but also goes beyond medical care, providing emotional and spiritual support that most Americans believe is an important aspect of end-of-life care.Hospice care is provided by a multi-disciplinary care team comprised of doctors, nurses, home health aides, social workers, clergy, and trained volunteers. Hospice care typically is provided in the home, allowing the patient to stay in a familiar setting surrounded by family and friends. Home is loosely defined, so terminally ill residents of nursing homes and assisted living facilities can receive hospice care without having to consider moving.Medicare, Medicaid and most private health insurance plans provide coverage for hospice services. The Medicare Hospice Benefit is an all-inclusive benefit and includes coverage for physician services, nursing care, home medical equipment and medical supplies, prescription drugs and over-the-counter medications related to the patients terminal illness, counseling, spiritual support and bereavement support for the patients loved ones. Patients and their families receive all benefits without any additional co-pays or ancillary payments.Editors Note: This article was submitted by Robin Marshall, General Manager of VITAS Innovative Hospice Care of New Jersey North. For more information about hospice, visit the National Hospice and Palliative Care Organization, www.nhpco.org, or call VITAS at 973-994-4738.

HOW TO FIND THE RIGHT HOME CAREThere are two types of support you can have in your homehome health and home care. They sound similar, but are quite different. After a stay in the hospital, a doctor might require someone to have care at home on a short-term basis. This is home health. It could be to monitor a health problem or manage wound care, among other things a skilled nurse can do. Your doctor or hospital will arrange for home health, which is paid for by Medicare. If your doctor does not prescribe home health, and you pay for services out of your own pocket or through private insurance, you can receive home care. There are various categories of home care, such as companion/homemaker service, wheelchair escort service, nursing service, and home support aide service. When you look for home care, its important to ask the right questions. Ask about the organizations employees. Make sure the nurses are licensed and the aides are certified. The initials after a persons name designate their licensure or certification. For example, RN is for Registered Nurse; LPN is for a Licensed Nurse Practitioner; PT is for Physical Therapist; and CNA is for a Certified Nursing Assistant.Ask about the hiring practices. Does the organization conduct background checks and/or reference checks on all their employees? What about drug screening? Make sure the organization follows rigorous hiring practices.Ask about supervision of the employees. If there is a problem with an employee, what can the customer do? If an employee doesnt show up for work, what happens? You want an agency that supervises their people and provides problem solving.Ask about anything else that is important to you. If it is important to you to have the same caregiver over a period of time, ask that question.Above anything else, Make sure you choose home care carefully so you get the quality you deserve. Editors note: This information was provided by Cecile Sutherland, MS, BSN, R. She has extensive healthcare experiences gained through increasingly demanding and responsible leadership positions in nursing homes, hospitals and out patient surgery centers. Cecile can be reached at 973-746-0165

As the year begins to draw to a close we are surrounded by Holidays. The stores are filled with Halloween candy in August, Thanksgiving decorations in September and October is already filled with Christmas.Whatever your familys religious beliefs are everyone has traditions such as gatherings and events which are unique and special. You may find yourself wondering how you will get through this time with one less sitting at the table. Here are strategies you can use to help you cope:1) Stay connected to your feelings - Give yourself time and permission to feel and express your emotions in the manner that works best for YOU (e.g., writing, sharing with someone close, meditating). Everyone has their own style.2) Focus on what is helpful for you and your family in the present - Old traditions may be too painful, especially in this first year. It may be easier to break with tradition and celebrate the holidays differently (e.g., if you always spend the holidays at your home, spend them at someone elses home).3) Create new traditions - By incorporating memories of your loved one into your holiday celebrations, you develop ways to honor their memory (e.g., have a poem or prayer read in your loved ones honor, create a memory quilt or light a candle).4) Do not feel guilty about how you feel - It is OKAY if you find some joy this holiday season. If you find no joy, this is also OK. Dont try to live up to others expectations of how you should feel. Grief is very individualized and can even vary with different losses. Instead of carrying expectations of how you SHOULD FEEL, accept the reality of how you DO FEEL. It is normal to have mixed emotions during the bereavement process and this is especially so during the holidays.5) Find ways of giving to others - When you are feeling sad and empty inside, it can be helpful to reach out to others. Some families volunteer in soup kitchens, create a memorial fund in memory of their loved one, or raise money that helps others etc.6) Avoid overindulgence with alcohol and food - There is an increased risk for eating and drinking too much during periods of bereavement and this is especially so during the holiday season. Eating and drinking too much are often ways of avoiding or masking underlying emotions so that they do not have to be felt. This is not a solution and only serves to prolong the intense feelings associated with your loss. 7) Explore the traditions of your faith concerning mourning and remembering - Even if you have not been involved in your faith, you may find comfort and support in these traditions.8) Be honest with yourself, don't be afraid to seek professional help - If you find yourself immobilized by your grief, feeling overwhelmed by emotions, or have other adverse experiences or behaviors, PLEASE seek professional help or call 1-866-821-1212 and ask to speak with a member of the Care Alternatives Bereavement Team.Editors Note: This article was submitted by Care Alternatives. They can be reached at 866-821-1212 or you can visit their website at www.carealt.com