Category: Terminal Illness

Articles about terminal illnesses that one typically sees and cares for on hospice.

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.

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

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 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

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.

Read MoreUnmanaged Pain in Dementia Patients

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

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

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

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.

Read MoreReviewing Hospice Eligibility

Understanding Discomfort: Distinguishing it from Pain While Caring for Your Terminally Ill Loved One

An Elderly Woman Who Is Uncomfortable

Caring for a terminally ill loved one is a profound and challenging journey that requires compassion, understanding, and a willingness to alleviate any discomfort they may experience. In this guide, we will explore the concept of discomfort, its distinction from pain, and the importance of recognizing and addressing discomfort in addition to pain. You'll be better equipped to provide holistic care that enhances your loved one's quality of life during this sensitive time.

Throughout your loved one's illness, you might find yourself thinking that they don't require "pain medication" because they don't seem to be in pain. They might even respond with a direct "no" when asked about their pain. However, are you aware that most types of pain medication can alleviate discomfort? Did you also know that your loved one could be feeling uncomfortable without necessarily being in severe pain? Nonetheless, it's important to recognize that their discomfort requires the same treatment as if they were in pain.

Read MoreUnderstanding Discomfort: Distinguishing it from Pain While Caring for Your Terminally Ill Loved One

Eye-Opening Lessons on Trusting Nursing Facilities: Advocating for Comfort in End-of-Life Care

Empty Hospital Bed At A Nursing Facility

As an experienced hospice visiting registered nurse, today offered me profound insights from two interconnected perspectives. The first highlights the blind trust we often place in facility nurses and doctors when caring for our loved ones. The second involves the challenges I encountered while advocating for proper end-of-life care for a patient with Alzheimer's.

Read MoreEye-Opening Lessons on Trusting Nursing Facilities: Advocating for Comfort in End-of-Life Care

The Actively Dying Phase of The Dying Process

Signs Indicating Death Is Imminent

For a non-healthcare professional who has never witnessed death before, it can be unsettling to be present with someone who is nearing the end of their life. However, there are certain signs and observations that you can make using your senses that may indicate that the person you are with may pass away within seconds, minutes, or hours. Understanding these signs can help you provide support and comfort to the individual and their loved ones during this grim time.

Read MoreThe Actively Dying Phase of The Dying Process

Breathing Patterns Before End of Life: Critical Clues for the Last Hours!

Breathing Patterns

Understanding the final breath: This article explores the critical breathing patterns observed in the last hours of life, offering insights for caregivers and family members to prepare for the end-of-life journey.

Read MoreBreathing Patterns Before End of Life: Critical Clues for the Last Hours!

The Transitioning Phase of The Dying Process

Signs of imminent death

Losing a loved one is an incredibly challenging and emotional experience. If you find yourself in the presence of someone in the transitioning phase of the dying process, knowing what signs to look for can be helpful. Although every individual's experience may vary, some common observations may indicate someone is in the transitioning phase. Here's a guide to help you recognize these signs and provide support during this grim time.

Read MoreThe Transitioning Phase of The Dying Process

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.

Read MoreUnderstanding the Role of IV Fluids at the End of Life

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.

Read MoreThe Life of Least Regrets

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. 

Read MoreTube Feeding on Hospice — Increased Risk of Your Loved One Suffering

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.

Read MoreMy name is Peter, yet the patient called me “Jack”

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.

Read MoreClues for terminal restlessness often missed for facility patients

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.

Read MoreTwo days…. until…

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.

Read MoreDetecting Infections in Terminally Ill Geriatric Patients with Dementia

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:

Read MoreShould dying patients be on oxygen?

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