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When A Residential Care Community Is An Option for Temporary Hospice & Palliative Care

Hospice is not a place. Hospice is a “concept of care” designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments.1 The goal of hospice care is to provide patients with comfort and dignity at the end of life with a special emphasis on controlling pain and discomfort and managing symptoms. The focus is on compassionate caring not curing. Hospice care neither hastens nor prolongs life, but this specialized service has been shown to increase quality of life. Hospice is covered by Medicare and Medicaid and most private insurance companies to eligible patients referred by a physician. Hospice services include care by professionals and volunteers and medication, equipment, and medical supplies. Families have no out-of-pocket expenses other than the cost of room and board. The patient and family are at the center of hospice care. The hospice team works with the patient and family to develop a personalized plan of care that respects the individual’s end-of-life wishes. A multi-disciplinary team of physicians, nurses, home health aides, social workers, therapists, spiritual counselors, bereavement counselors, and volunteers provides expert and compassionate care that is available 24 hours a day, 7 days a week. Physicians and nurses are specially trained to address pain and manage symptoms. The team works closely with family members to provide feeding, bathing, turning, administering medications, and monitoring changes in a patient’s condition. Some hospice providers provide alternative therapies such as Pet Therapy or Music Therapy. Spiritual counselors, therapists, and social workers help patients and families with emotional and spiritual concerns and provide bereavement support to family members after a loved one has died. Most people choose hospice care in their own homes, but hospice care is also available in hospitals, nursing homes, and residential care communities for the elderly such as assisted living communities and board and care homes. In 2011, 66.0% of hospice patients received care in the place they call “home,” including private residences (41.5%), skilled nursing facilities (17.2%), and residential communities (7.3%).2 When hospice care is not an option at home, nursing homes, freestanding hospice facilities, and residential care communities like board and care homes are places for families to turn for short-term respite or longer term care at the end of life. The Board and Care model, which provides residential care for fewer residents in a private home, offers a home-away-from-home in an intimate environment that provides a home-like routine and a place for family to gather. Board and Care homes can offer temporary hospice to residents and families who request it. These homes typically work with a number of hospice organizations to provide families with choice for high quality care. The board and care staff coordinate care with the hospice staff and they may provide bedside comfort tailored to the resident’s needs and preferences, such as soft music, reading, and aromatherapy. “Choosing a hospice to care for yourself or a loved one in the final months or even days of life is an important and stressful process,” said J. Donald Schumacher NHPCO president and CEO. “Each hospice offers unique services and partners with specific community providers – so it’s important to contact the hospices in your area and ask them questions to find the one with the services and support that are right for you.”3 For additional information on hospice and how to select a quality hospice provider, families may turn to online resources found at the National Hospice and Palliative Care Organization (www.nhpco.org) and the Hospice Foundation of America (www.hospicefoundation.org). References: 1Hospice Foundation of America. www.hospicefoundation.org. 2Facts and Figures: Hospice Care in America. 2013 Edition. National Hospice and Palliative Care Organization. www.nhpco.org. 3Choosing a Quality Hospice. National Hospice and Palliative Care Organization. www.nhpco.org.   Trina Duke, Master of Science in Gerontology Concierge Gerontology Services
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Helping Loved Ones with Dementia Cope with the Loss of a Spouse

There are creative and effective ways to help an aging parent, family member or loved one who suffers from Alzheimer’s disease or dementia cope with the loss of their spouse, according to a new survey of aging experts released this week by the National Association of Professional Geriatric Care Managers (NAPGCM). Remembering that there are different stages and types of dementia, making sure the surviving spouse does not become socially isolated and not rushing other major changes in their lives are among the top expert recommendations. Americans are increasingly challenged by the need to communicate difficult information to aging family members with dementia. According to the National Institutes of Health as many as 5 million of the 43 million Americans age 65 and older may have Alzheimer’s disease and another 1.8 million people have some other form of dementia. And, according to the the number of Americans with Alzheimer’s disease and other dementias will escalate rapidly in coming years as baby boomers age. By 2050, the number of people age 65 and older with Alzheimer’s disease may nearly triple, from 5 million to as many as 16 million, barring the development of medical breakthroughs to prevent, slow or stop the disease. June is Alzheimer’s and Brain Awareness Month. NAPGCM is releasing the results of its latest survey to help American families facing one of the most difficult of these challenges. NAPGCM polled 288 professional geriatric care managers in Los Angeles, CA and across the country asking them to identify the most effective strategies for helping a loved one with dementia cope with the loss of their spouse. The top six strategies identified by the aging experts are: 1. Remember there are many different stages of dementia. Your loved one’s capacity for understanding, coping and grieving can be very different depending on their stage of dementia. (Identified by 96% of survey respondents) 2. If your loved one’s response to reminiscing about their spouse is positive, share old photos and memories. (88 %) 3. Make sure the surviving spouse is not socially isolated. Schedule visitors on a regular basis and help them keep up with any normal social routines they have. (85%) 4. Reassure them there are people who care about them and will care for them. (84%) 5. Don’t rush big changes. It may make sense for them at some point to move to a facility, or closer to family. But, if possible, give them time to adapt so there aren’t too many major life changes at once. (81%) 6. If they choose to be included in mourning rituals for their spouse, make sure there is someone overseeing this so if the situation becomes too stressful they can leave. (78%) “With the rising rates of Alzheimer’s disease and dementia in our community, we often see families who face such challenging situations,” said Trina Duke, Gerontologist and Care Manager, Los Angeles, CA. “Our survey findings offer some sound expert advice for families.” The Alzheimer’s Association is a leading resource for families seeking information on the diagnosis, treatment, and stages of the disease. Their website provides information on living with Alzheimer’s and other dementias, tips for caregivers, and financial and legal planning. Go to www.alz.org. Help is only a phone call away on their 24/7 Helpline at 1-800-272-3900. Local chapters provide educational programs, community support groups, and creative workshops for persons with dementia and their caregivers. The Alzheimer’s Association California Southland Chapter assists people with Alzheimer’s and their families and educates the public about Alzheimer’s disease. The chapter offers a variety of diverse programs and services. It serves the diverse counties of Los Angeles, Riverside, San Bernardino, Inyo, Kings, Mono and Tulare.
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