Author: Peter Abraham, BSN, RN

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Peter Abraham is a seasoned nurse committed to supporting nurses, caregivers, families, and patients in their learning, growth, and well-being journey. His extensive nursing career includes practical experience as a cardiac telemetry nurse in a dynamic cardiology unit at a Magnet-awarded teaching hospital. Additionally, Peter has served as a second-shift RN supervisor, managing an entire building in a Skilled Nursing Facility/Long-Term Care (SNF/LTC) setting with 151 residents. Notably, during the initial wave of COVID-19, the facility achieved an impressive near-100% recovery rate before the completion of Operation Warp Speed.

Peter's nursing career also extends to rural home hospice care. As a visiting hospice registered nurse case manager, he provides compassionate care to patients in various settings, including private homes, personal care homes, assisted living facilities, skilled nursing facilities, and hospitals. His dedication to compassionate care led to the establishment of the Peter Abraham Wound Care Scholarship, which offers education in wound care. This scholarship, associated with the theme of "Wound Care: Enhancing Healthcare for the Aging Population," underscores Peter's commitment to improving care for those in need.

Peter is the author of Empowering Excellence in Hospice: A Nurse's Toolkit for Best Practices, Holistic Nurse: Skills for Excellence, Compassionate Caregiving, and the Dementia Care Essentials series on Amazon. His work aims to provide valuable resources and guidance for hospice care professionals, ensuring that patients and their families receive the best possible support during challenging times.

Beyond his hands-on care, Peter also writes articles to empower caregivers, family members, and fellow nurses in end-of-life care. His passion for helping others is deeply rooted in his love of Christ Jesus. To learn more about Peter, you can listen to an interview by Marie Betcher, RN, on her Hospice Explained Podcast Series, as well as subscribe to his YouTube channel at https://www.youtube.com/@NursePeter

Considering Home Hospice vs. Hospice at a Facility: Making an Informed Decision

Where Do Most Hospice Patients Receive Hospice Care

Deciding on end-of-life care for a loved one is challenging and emotional. One major decision to make is whether to opt for home hospice or hospice care at a facility. Both options have advantages and drawbacks, and understanding the pros and cons can help families make an informed choice. Here, we'll explore the pros and cons of each option and provide key questions that families should ask themselves to aid in their decision-making process.

Read MoreConsidering Home Hospice vs. Hospice at a Facility: Making an Informed Decision

Why Patients with Dementia Thrive in a Family Home Setting

Dementia Patient With Family Members

As an experienced hospice registered nurse case manager specializing in compassionate end-of-life care, I've had the privilege of working closely with terminally ill patients, including those battling dementia. Through years of dedicated service, I've observed a significant difference in the well-being and quality of life of dementia patients in family home settings versus facility-based care. In this article, we'll explore why patients with dementia often experience better outcomes in the comfort of a family home.

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The Hospice Liaison: A Key Role in Hospice Care

hospice liason

This position involves being the first point of contact for families, patients, and facilities, making a lasting impression by offering both compassion and confidence in explaining hospice services. In this discussion, we will delve into the various aspects of the role of the Hospice Liaison, bringing insight from forever Christmas-loving Kathy Naccarato, including its dynamic nature, your dedication to dispelling misconceptions, and the importance of building relationships within the healthcare community.

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Understanding Lewy Body Dementia: A Guide for Families

Lewy Body Dementia (LBD) is a complex and challenging condition that affects millions of individuals worldwide. As a hospice nurse with years of experience, I understand the importance of providing families with clear and compassionate information about what to expect when a loved one is diagnosed with LBD. This article will discuss what LBD is, its common symptoms and progression, and practical tips for providing care and support throughout the journey, from onset until the end of life.

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Understanding Functional Decline in the Natural Dying Process

Explore the journey of functional decline in the natural dying process. This article provides insight for caregivers and families, emphasizing the importance of documenting changes to enhance care and decision-making in life’s final chapter.

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Importance of Medication Reconciliation in Hospice Care

Medication Related Errors Are The 3rd Leading Cause Of Death In The Usa

Medication reconciliation plays a pivotal role in hospice care, ensuring terminally ill patients receive safe medication regimens. This process involves maintaining an accurate medication list to prevent adverse drug events. It's essential at various stages, including admission, recertification, and changes in condition. Healthcare professionals should be familiar with tools like the Beers Criteria and STOPP/START criteria to identify potentially inappropriate medications and prescribing omissions in older adults.

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Understanding the Decline of Terminally Ill Loved Ones: Medications vs. Disease Processes

Illness Trajectories And Palliative Care

When a loved one is terminally ill, it can be a perplexing and emotional journey. Understanding the root cause of their declining health becomes paramount. It's a complex puzzle where family members often grapple with questions: Are the symptoms a result of medications prescribed, or are they intrinsic to the terminal disease? This article delves into the critical distinctions between medication side effects and the natural progression of terminal illnesses, offering insights to empower families and caregivers in making informed decisions about their loved one's care.

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Early Detection of Serotonin Syndrome in Dementia Patients: Three Case Studies

Serotonin syndrome is a potentially life-threatening condition caused by an excess of serotonin in the body. Detecting this condition early is crucial, but it can be particularly challenging when dealing with dementia patients due to communication barriers and the complexity of their symptoms. In this article, we will present three case studies that highlight the early detection and successful management of serotonin syndrome in patients with different types of dementia: Alzheimer's disease, vascular dementia, and Lewy Body Dementia.

Read MoreEarly Detection of Serotonin Syndrome in Dementia Patients: Three Case Studies

Understanding Serotonin Syndrome: A Comprehensive Guide

clinical presentation of serotonin syndrome

Hospice nurses assess the status of the patient's journey towards the end of life every nursing visit. Situations where a reversible condition can drastically impact the patient and the hospice assessment can occur. If it is not caught, it is potentially mistreated, leading to increased discomfort and a faster death, often involving increased suffering. One of the common clues that someone is getting closer to dying is increased agitation and restlessness.

Are you aware of Serotonin Syndrome?

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Trigger Words for Hospice Nurses: Assessing End-of-Life in Two Weeks or Less

Signs of imminent death

Discover key indicators for end-of-life care in hospice. This guide highlights ‘trigger words’ that signal a patient’s final days, aiding nurses and caregivers in providing compassionate support during the most critical moments.

Read MoreTrigger Words for Hospice Nurses: Assessing End-of-Life in Two Weeks or Less

Understanding Vascular Dementia: A Guide for Families

If your loved one has been diagnosed with Vascular Dementia, it is natural to have questions and concerns about what lies ahead. This educational article aims to provide you with an overview of what to expect over the course of the disease, the changes you might see in your loved one, and how to best care for them from onset until the end of life.

Read MoreUnderstanding Vascular Dementia: A Guide for Families

Dispelling Myths About Hospice Care

Hospice care is often misunderstood and shrouded in myths that can prevent individuals and families from accessing the compassionate support they need during a challenging time. This article will address common misconceptions about hospice care and provide you with the facts. We aim to empower you with accurate information to make informed decisions when considering hospice for yourself or a loved one.

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Unmanaged Pain in Dementia Patients

Dementia is a condition that affects millions of people worldwide, and it can cause a range of symptoms, including pain and discomfort. Unfortunately, pain is often under-detected and undertreated in people with dementia, leading to significant suffering and a reduced quality of life. In this article, we will explore the prevalence of pain among dementia patients, the impact of unmanaged pain on their quality of life, behavioral changes that may indicate pain, and the use of the PAINAD pain scale as a tool for assessing and managing pain in dementia patients.

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Understanding and Avoiding Caregiver Burnout when Caring for a Loved One with Dementia

coping with caregiver burnout

Caring for a loved one with dementia can be a rewarding experience, but it can also be physically, emotionally, and mentally exhausting. Family caregivers often neglect their own well-being while focusing on the needs of their loved ones, leading to burnout. Caregiver burnout is a state of physical, emotional, and mental exhaustion that can happen when caregivers don't get the help they need or try to do more than they are able to do. In this article, we will discuss how family caregivers of a loved one with dementia can avoid burnout and recover if they are already experiencing burnout.

Read MoreUnderstanding and Avoiding Caregiver Burnout when Caring for a Loved One with Dementia

Caring for a Loved One with a History of Diverticulitis

Caring for a loved one with a history of diverticulitis requires a combination of preventive measures, early detection of warning signs, and understanding the common signs and symptoms of this condition. Your role as a caregiver is crucial in providing support and assistance to ensure their well-being. In this comprehensive guide, we will explore essential aspects of caring for someone with diverticulitis, including prevention, early warning signs, and treatment options.

Read MoreCaring for a Loved One with a History of Diverticulitis

Unlocking the Power of Validation Therapy in Compassionate End-of-Life Care

In the realm of hospice care, where empathy and compassion are paramount, a remarkable approach called Validation Therapy has emerged as a beacon of hope and comfort for individuals facing dementia and cognitive disorders in their final journey. As an experienced hospice registered nurse case manager, I've witnessed the transformative impact of Validation Therapy on patients, allowing them to find solace, regain their self-worth, and experience a sense of dignity during their end-of-life phase.

Read MoreUnlocking the Power of Validation Therapy in Compassionate End-of-Life Care

Understanding and Addressing a Terminally Ill Patient’s Fear of Impending Doom

Yet Another Holding Hands Picture

I understand how challenging it can be for terminally ill patients to cope with their fear of impending death. It is crucial for both healthcare providers and family members to take these feelings seriously and respond with compassion and understanding. In this article, we will explore the importance of acknowledging a patient's fear of impending doom and discuss actions that families can take to provide peace and comfort during this grim time.

Read MoreUnderstanding and Addressing a Terminally Ill Patient’s Fear of Impending Doom

Promoting Meaningful Relationships with Dementia Patients through Validation Therapy

Caring for individuals with dementia can be both challenging and rewarding. One approach that has gained recognition for promoting meaningful relationships with dementia patients is Validation Therapy, developed by Naomi Feil. This article will explore how Validation Therapy works, why it does not involve telling a single lie, and why honesty is crucial when dealing with dementia patients.

Read MorePromoting Meaningful Relationships with Dementia Patients through Validation Therapy

Recognizing Signs of Dementia in Your Loved One

signs of dementia

Dementia is a condition that affects cognitive abilities such as thinking, remembering, and reasoning. It is crucial to recognize the signs and symptoms of dementia early to provide proper support. This article will help you understand the common signs and symptoms of dementia and steps you can take to address them.

Read MoreRecognizing Signs of Dementia in Your Loved One

The Hospice Chaplain

sun setting over mountains

In this article, we will explore the vital role of a hospice chaplain, as explained by Katherine Seiler, an experienced and compassionate hospice chaplain. Hospice chaplains play a significant role in providing emotional, social, and spiritual support to terminally ill patients and their families during their end-of-life journey.

Read MoreThe Hospice Chaplain

Frontal Lobe Dementia: Understanding and Caring for Your Loved One

Facing a loved one's diagnosis of frontal lobe dementia can be overwhelming and challenging. This article aims to provide families with essential information about frontal lobe dementia, its progression, changes they might observe in their loved one, and best practices for caregiving from onset until the end of life.

Read MoreFrontal Lobe Dementia: Understanding and Caring for Your Loved One

Caring in Crisis: Navigating the Challenges of Hospice Care in 2023

history of the hospice movement

Hospice care is a vital form of healthcare dedicated to providing comfort and support to patients in their final stages of life. While it's a relatively recent concept in the United States, with its inception in 1974, it has gained significant popularity, with over half of Medicare beneficiaries in 2020 receiving hospice services. Nevertheless, as we delve into 2023, hospice care confronts several formidable challenges. These include labor shortages, concerns about the quality of care, and the notable presence of for-profit entities in the industry. In this article, we will navigate through the history of hospice care in the United States, its present state in 2023, and the challenges that affect not only hospice patients but also the dedicated staff and providers.

Read MoreCaring in Crisis: Navigating the Challenges of Hospice Care in 2023

Reviewing Hospice Eligibility

general hospice criteria

It’s essential to familiarize yourself with the key local coverage determination (LCD) facts for different terminal illnesses to avoid admitting patients who are not eligible for services only to be required to refund the money back to Medicare; otherwise, only have the patient on for one benefit period then discharged for failure to decline. These determinations provide guidelines on the coverage of hospice services for specific conditions. If you are the admitting nurse, please do not just admit because you were told to admit by someone, regardless of the position or standing of the person or party that told you to admit. Use your critical thinking and clinical judgment skills to evaluate the patient for admission. Most doctors will write "evaluate and treat" or something to that effect; never lose sight of the "evaluate" portion of the doctor's order.

Based on the provided PDF files, as noted in the resources section below, let’s explore some essential information for each terminal illness.

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Failure to Decline in Hospice – The Good and The Ugly

Live Discharge Flow Chart

If your loved one is facing a discharge from hospice due to failure to decline, it's crucial to comprehend the situation clearly. This discharge indicates that the healthcare team believes your loved one's condition has stabilized and no longer requires hospice care. While this might be a positive sign, it's important to weigh the pros and cons before making decisions. Let's delve into both the positive and negative aspects of this situation to help you navigate it effectively.

Read MoreFailure to Decline in Hospice – The Good and The Ugly
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