Category: Palliative Care
Articles about palliative care including the differences between palliative care and hospice care which is palliative care at end-of-life.
Preventing Friction and Shear Injuries in Elderly Care: A Guide for Non-Health Professionals
Taking care of an elderly fragile person at home can be both rewarding and challenging. One crucial aspect of caregiving is preventing friction and shear injuries, which can be painful and detrimental to the person's well-being. In this article, we'll explore what friction and shear injuries are, how they can be avoided, and some practical tips to ensure your loved one's safety and comfort.
The Power of Empathy in Hospice Care
It's common in nursing to be told by others that you shouldn't be a nurse, and some may even call you a "fake nurse" if you don't meet their standards of what they think is required to be a nurse. The first time I was told I could not be a nurse was by an elderly woman who believed only women could be nurses.
Is Dying Painful?
Dying doesn’t always hurt. The amount and type of pain there is at the end of life can differ. The specific diagnosis and cause of pain are factors.
Understanding Hospice Care: Is it Too Early to Start Hospice?
Is it Too Early to Start Hospice?
It's crucial to remember that hospice care is about improving the quality of life for the patient and their family, regardless of the time left. Hospice care can be initiated when the patient's condition is declining and they require comfort-focused care rather than life-prolonging treatments. Starting hospice care early can provide ample time for the patient and their family to benefit from the support and services offered.
If you're unsure when to consider hospice care, consult the patient's primary physician or a hospice care provider. They can guide you through the process and help you make an informed decision based on the patient's needs and circumstances.
Understanding the Role of IV Fluids at the End of Life
Explore the delicate balance of IV fluid use at life’s end. This article discusses the hospice approach, potential risks, and prioritizing comfort over invasive measures. A must-read for families facing tough decisions in palliative care.
Empowering Hospice Nurses: Conquering Medicare Audits and Improving Documentation for Better Patient Care
This article provides valuable insights for hospice nurses on improving documentation to conquer Medicare audits and ensure claims are not denied due to insufficient evidence of terminal prognosis. The author shares real-life examples of visit narratives before and after implementing documentation best practices learned from an expert. The tips focus on capturing negative condition changes, disorientation levels, and functional decline to paint a clear picture of the patient's terminal state, ultimately leading to better patient care.
What Does Hospice in a Home Setting Look Like?
Caring for a terminally ill loved one can be challenging. Still, with the proper support and understanding, you can help ensure they experience a comfortable and dignified end of life. Hospice care offers specialized medical and emotional support during this time. This guide aims to empower families new to hospice services by providing essential information on what to expect from a hospice provider and how to manage the journey towards a good death.
Educating Facility Staff on What Matters for Terminally Ill Patients
Educating nursing home staff on hospice care priorities like shifting focus from vital signs to comfort, managing symptoms like pain/breathlessness, providing psychosocial support, end-of-life planning, and bereavement care is crucial. Hospice emphasizes quality of life over curative treatments. Effective symptom management through medications and non-pharmacological approaches enhances patient comfort. Open communication, empathy, and respecting patient autonomy are essential. Hospice prepares families for the dying process and grief counseling.
The Life of Least Regrets
The longer I work in hospice, the more I'm reminded about two critical pieces of wisdom: 1) Hospice is about living, and 2) we should all do our best to live a life of least regrets.
While this article is geared towards family members with a terminally ill loved one, as well as my fellow workers in the fields of palliative and hospice care, I believe the thoughts that I will share apply to everyone alive near and far.
Review of the Hospice Documentation Master Bundle
Whether you are a new hospice nurse or an experienced one like me, I would hope that it is your desire to prove and support continued hospice eligibility for your patients and families. In my years as a hospice nurse, I've always felt the training on what words and phrases to use to support hospice eligibility was weak compared to the training received in other areas of nursing. Now, you have a means of getting the education you need in a very portable setup that you can take with you, use as you see fit, and bloom!
Tube Feeding on Hospice — Increased Risk of Your Loved One Suffering
Considering tube feeding for a loved one in hospice? This intervention may not improve quality of life and can lead to discomfort, reduced mobility, and complications. Learn about the risks and make informed decisions for their end-of-life care.
The Ins and Outs of Hospice Patients Seeing Their Regular Doctor and Specialists
When it comes to hospice care, one common question that arises is whether terminally ill patients should continue seeing their regular doctor or specialists. As an experienced hospice nurse, I have witnessed the benefits and challenges of maintaining these relationships. In this article, we’ll explore the pros and cons of hospice patients still visiting their general practitioners and specialists from the perspective of patients and their families.
A Day In The Life Of A Hospice Nurse
What does a typical day, a typical week look like for a visiting hospice registered nurse case manager look like?
My name is Peter, yet the patient called me “Jack”
As a hospice registered nurse, I have encountered numerous heartwarming and challenging experiences throughout my career. One of the most memorable encounters was with a dementia patient, Miss Norma Jean Smith, who affectionately called me "Jack." This endearing nickname, born out of her unique perception, became a symbol of the special bond we shared. In the following account, I will share the poignant journey of building trust, providing compassionate care, and embracing the unexpected moments of joy and sorrow in the life of Miss Norma. This story is a testament to the profound impact of person-centered care and the invaluable lessons learned from the patients we are privileged to serve.
Understanding HIS Requirements for Medicare in Hospice Care
One crucial aspect for new hospice nurses to grasp is the Hospice Item Set (HIS) requirements. In this article, I’ll explain the HIS requirements for Medicare, providing you with a comprehensive understanding to ensure compliance and quality care delivery.
Clues for terminal restlessness often missed for facility patients
One of the hardest portions of the job of a hospice nurse is to identify when a patient has two weeks of life left to live; this can be especially difficult at facilities going through staffing shortages leading to inconsistent caregivers with little to verbally report on a patient’s change of condition. Since being aware of the velocity of declines is extremely important, let’s cover an area that we in hospice (nurses, families, and caregivers alike) can keep an eye on in terms of identifying terminal restlessness which is often a key indicator for one week or less of life.
Effectiveness of topicals for pain and anxiety management
I have seen firsthand the benefits and drawbacks of different medications for managing pain and anxiety in terminally ill patients. Fentanyl patches and Ativan gel are two commonly used medications, but their effectiveness can vary depending on a patient’s build and weight, particularly for very thin or cachexic individuals.
Two days…. until…
There is a spiritual connection in hospice, dealing with death and dying forty-plus hours per week. We who are in the field see it often, but there are times when we hear it firmly from the patients and families whom we serve. Let me share the most recent event on Memorial Day, 5/29/2023, week.
How Hospice RN Case Managers Can Reduce After-Hour Calls
I understand the challenges that patients and families face when receiving hospice services. One common issue that arises is the need for after-hour calls, which can add stress to an already demanding situation. However, with proactive care and effective communication, dayshift hospice RN case managers can play a crucial role in reducing after-hour calls and providing better support to patients and their families. Here’s how:
Detecting Infections in Terminally Ill Geriatric Patients with Dementia
One of the most important roles is detecting and managing infections in terminally ill geriatric patients with dementia. These patients are often at higher risk for infections due to their weakened immune systems, underlying health conditions, and limited mobility. Detecting infections in these patients can be challenging due to their limited communication abilities and other cognitive and physical impairments. However, early detection and management of infections can significantly improve the patient’s quality of life and potentially prolong their life.
Ethical Dilemmas in Hospice
As a hospice RN case manager, I have seen many ethical dilemmas arise in end-of-life situations. Hospice care is unique because it focuses on providing comfort care to patients no longer seeking curative treatment for their illnesses. As a result, the ethical concerns in hospice care differ from those in other healthcare settings. This article will explore some ethical dilemmas that can arise in hospice care and how they can be addressed.
Before I review several case studies gathered from the sources in the resource section below, please allow me to share a current one of mine that is ongoing as this article is being published.
What Hospice Nurses should assess every visit
Hospice nurses play a vital role in providing quality care and comfort to terminally ill patients and their families. They must make accurate and timely assessments of the patient’s condition, needs, and preferences every visit. This article will outline the key aspects that hospice nurses should assess every visit, in addition to the standard physical assessment.
Should dying patients be on oxygen?
I have cared for many terminally ill patients over the years. One question that comes up frequently is should the dying patient be on oxygen at the end of life?
I see it from both sides, from hospice intake personnel as well as the admitting nurse — all had it drilled into them over the years that low oxygen saturation must be treated — to families who see how hospital and nursing home staff rush to put someone on oxygen because of low oxygen saturation.
Contrary to widespread belief, most dying patients do not need oxygen. Here’s why:
Frequency of Changes in Condition as an Indicator of Approaching Death
Recognizing the velocity of changes in a patient's condition is crucial for hospice nurses. By understanding the pace of changes in vital signs, symptoms, functionality, and more, nurses can anticipate needs, adjust care plans, and communicate the prognosis effectively with patients and families. The article provides guidelines on interpreting the velocity to estimate the time a patient has left.