Text JoinTeam to 97211 to learn more about career opportunities today!

Feeling Thirsty? Time to Drink Water!

As we sweat our way through the hottest months of the year, it is important to make sure we are adequately replenishing all of the fluid we are potentially losing. Between beach vacations, family picnics, and holiday parades, it can be easy to forget the last time you took a sip of water or find yourself in places where there isn’t any nearby. Below you will learn more about what dehydration is, how you can spot it, why it is particularly relevant to the elderly population, and what you can do to prevent it!

hand holding glass of water

What is dehydration?

Dehydration is defined as a dangerous loss of fluid from the body which can occur through illness via diarrhea and vomiting, sweating, or simply not consuming enough liquids. Dehydration can happen to anyone at any age, but it is particularly dangerous and more prevalent in the older population.

How does it affect the elderly?

For a number of reasons, older individuals are more susceptible to fluid loss and dehydration. In general, seniors have less total body water volume than younger adults and children. On top of this naturally lower level of water in their bodies, many older adults have conditions and are taking medications that can affect hydration levels and increase susceptibility to dehydration.

Furthermore, research has shown that one’s sense of thirst decreases as they get older. This decreased sense of thirst can result in underconsumption of water or not realizing one’s thirst until early dehydration has already begun to set in. In some cases, decreased mobility interferes with an older individual’s ability to get up and pour themselves a regular glass of water. Water is a critical component in nearly every function in the human body, and it comes as no surprise that dehydration is commonly behind hospitalizations and illness in the older adult population.

Signs and symptoms

As we discussed, many older adults will not realize they are thirsty until they are already in the early stages of dehydration. This makes spotting dehydration tricky and staying on top of hydration even more important. What you can look out for, especially in the older population, is extreme thirst, less frequent trips to the bathroom, dark-colored urine, fatigue or tiredness, dizziness and confusion. If you notice lasting signs and symptoms in yourself or your loved one, be sure to call a doctor.

Preventing dehydration

Instead of waiting until signs and symptoms of dehydration set in, planning ahead and implementing hydration tactics is the best way to protect against dehydration. For the older adult, there are quite a few ways to incorporate fluids without just forcing glass after glass of water, which can admittedly get boring and can also leave them running to the bathroom every five minutes. If you or a loved one that you are caring for struggles with drinking water, mixing half juice and half water can elevate the taste and make drinking fluids more enjoyable. Be mindful of the older adults with conditions such as diabetes, where sugar consumption will need to be monitored and carefully controlled. Many foods, especially fruits and vegetables, are full of water, which can aid in getting enough hydration if eaten throughout the day. Additionally, consider spacing out fluid and water consumption across a longer period of time during the day so you can tolerate the fluid while remaining hydrated and avoid bloating. Especially for the active older adult, electrolyte supplement packets or beverages can be a useful tool in preventing dehydration. Relevant electrolytes include sodium (salt), potassium, and glucose, and additional vitamins can add benefit. In order for our bodies to uptake water, there must be a high enough concentration of electrolytes and sugars present, which these packets provide.

Drinking these in addition to plain water results in quicker and more efficient hydration. When selecting these electrolyte supplements, be sure to note the concentration of electrolytes versus sugar ratio, as some popular “sport drinks” have higher sugar concentrations, which will be counterintuitive to your hydration status. If you only have access to these higher sugar beverages, use the half and half method of beverage to water to dilute your drink. If you don’t have access to electrolyte or sports drinks, you can make your own! Take your favorite juice, combine it with water, and then add a pinch of salt. Consider purchasing a large water bottle or tumbler that can provide adequate hydration throughout the day and holds enough fluid to require less trips to the filter. Always be aware that your loved one could have co-conditions that require specific fluid monitoring and check with their doctor before making changes to their diet.

elderly couple working outside in garden

References:

Image 1 – https://unsplash.com/s/photos/glass-of-water

Image 2 – https://www.healthline.com/health-news/walking-gardening-swimming-may-prevent-brain-shrinkage-in-older-adults-emb-1pm  

Cleveland Clinic – https://health.clevelandclinic.org/drink-up-dehydration-is-an-often-overlooked-health-risk-for-seniors/

Mayo Clinic –

https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086#:~:text=Dehydration%20occurs%20when%20you%20use,fluids%2C%20you%20will%20get%20dehydrated

grieving woman

Anticipatory Grief

When we think of grieving, we primarily think of grief following a loss. However, this is not the only form of grief. Anticipatory grief refers to the feeling of grief that occurs before an impending loss. This can go beyond the loss of the person. It can also be difficult to think about how the roles in your family will change or how different the future will look.

Compared to Grief After Death

While anticipatory grief is very similar to grief after death, there can also be a lot of differences in the experience. In grief after death, you are facing a loss that has already occurred and must figure out how you are going to move forward in your new reality. In anticipatory grief, you know you will have to face this loss at some point in the future, but you can’t know for sure when it will occur. You are in a sort of in-between state where your loved one is still here, but you know your time with them may be limited. This feeling can be more severe for some because you are trying to wrap your head around the idea of life without this person while they are still here.

Hospice

Although they may not think about the term for it, families with a loved one on hospice services are all too familiar with anticipatory grief. When you have a loved one on hospice services, you understand that they have a life expectancy of six months or less if the disease were to run its normal course. This means you are very much aware of the impending loss you are facing, which can oftentimes lead to anticipatory grief.

hug

Bereavement Services

Most people have likely heard about bereavement services that are offered through hospice. What you may not know is that you don’t have to wait until after the death of a loved one to start taking advantage of these beneficial services.

Bereavement services can start at any time throughout the hospice journey, including before death. The feelings of anticipatory grief can be confusing, but our compassionate team of bereavement coordinators can help you sort through these feelings.

It’s never easy to face the loss of someone you love. Although we cannot take away the pain you are feeling, we will do all we can to support you through your grief. If you or someone you love would like someone to talk to, please contact us. We will connect you with a highly trained, caring bereavement coordinator who will walk with you through your grief.  

Resources

How Anticipatory Grief Differs From Grief After Death – https://www.verywellhealth.com/understanding-anticipatory-grief-and-symptoms-2248855

Person’s meditating hands in a grassy field

Importance of Self-Care In Grief

We all grieve differently, but one thing remains true for everyone: the importance of taking care of yourself. Whether you’ve found yourself in a state of just going through the motions or you’ve put all your focus on taking care of your loved ones, it can be easy to put your own needs on the back burner when facing the loss of a loved one.

However, it’s absolutely imperative that you take time to focus on yourself, too. In honor of Mental Health Awareness Month, we are discussing the importance of self-care throughout the grieving process.

Mental Health Awareness Month

Mental Health Awareness Month dates all the way back to 1949 when the National Association for Mental Health (now known as Mental Health America) first organized the observance in the month of May to help raise awareness and lessen the stigma attached to mental illness.

For a long time, society looked at mental illness as being just one thing. There was always a negative stigma attached to the term, and people often thought of those living with a mental illness as having ‘gone mad’. However, that is simply not true. Over time, we’ve learned more about the many layers and types of mental illness.

Mental illness is the term used to describe mental health conditions that impact a person’s mood, thinking, and behavior. Common mental illnesses include:

How Grief Impacts Mental Health

Losing a loved one can be a traumatic experience. You may feel as though you lost a part of yourself and that your life will never be the same. While there is some truth to this, it’s important to remember that you are still here and must go on living your life.

“We don’t move on from grief. We move forward with it.

–          Nora McInerny

Feelings of sadness, anger, loneliness, and hopelessness are all common throughout the grieving process. However, these feelings can sometimes develop into chronic grief which can in turn become a mental illness. In some cases, grief can lead to depression.

Symptoms of chronic grief can include:

How Self-Care Improves Mental Health

Self-care used to be thought of as bubble baths and pampering yourself, but there is much more to self-care. Just like the grieving process, self-care can look different for everyone. But the overall concept is to take care of yourself physically, mentally, and emotionally.

To take care of yourself physically is pretty simple: eat a well-balanced diet, drink plenty of water, exercise regularly, and practice healthy hygiene habits. However, taking care of yourself mentally is a little less cut and dry. This is where it really differs from person to person. To take care of yourself mentally and emotionally, you need to take time to do the things that make you feel good and happy. Hobbies are a good place to start when focusing on taking care of yourself mentally. Maybe you enjoy sitting outside and reading a good book, maybe you are an artist, maybe you enjoy taking long walks with your dog. Whatever it is that leaves you feeling happy and fulfilled, do it!

Research shows the more you practice self-care, the more confident, creative, and productive you are. This also leads to experiencing more joy, making better decisions, building stronger relationships, and communicating more effectively. Overall, you will be in a better frame of mind, making you a better version of yourself. This is not only good for you, but it’s also good for those who depend on you.

When you take time to take care of your whole self (physically, mentally, and emotionally), it will help you to process your feelings of grief in a healthier way.

How Hospice Can Help You in Your Grief Journey

Always remember that you do not have to face the journey of grief alone. Lean on friends and family to help you through. Don’t be afraid to talk about your feelings. Sometimes we feel the need to be strong for those around us. If this is the case and you would feel more comfortable talking to someone outside the family, lean on the support of your hospice bereavement team. Our kind, compassionate bereavement coordinators are always available to talk or just listen. Never hesitate to reach out.

If you or someone you love is struggling with their feelings of grief and would like to talk to one of our bereavement coordinators, please contact us at (619) 450-4414.

Collage of people

Asian American and Pacific Islander Heritage Month

By: Anonymous

May is Asian American and Pacific Islander (AAPI) Month, a time to learn about and celebrate the rich histories and cultures of Americans from the Asian continent and the Pacific Islands. The AAPI population is remarkably diverse, with 24 million people tracing their roots to over 30 countries. Many different cultures mean many different beliefs and traditions regarding the passage from life to death.

Demographic research reveals that AAPI Americans are less likely to access hospice and palliative care than other groups. Asian Americans, for example, have been shown to use fewer end-of-life services. Studies attribute this to cultural beliefs, language barriers, attitudes about death, and family-centered decision-making. But good hospice and home care can meet these challenges.

Respecting Differences

We recognize that the AAPI community has diverse attitudes and practices surrounding illness, hospice, and death.

Although some AAPI practices are widely shared, such as respecting elders, using white and yellow colors, and burning incense, some practices vary. Chinese and Korean values can require the family to keep vigil by a dying loved one. The Chinese tradition, however, may maintain a hierarchy within the family structure, while the Korean tradition might maintain the division of genders. In other AAPI traditions, individuals, like expectant mothers, are discouraged from visiting someone at their end-stage of life for their own protection. In addition, some cultures place great value on a loved one being cared for in their own home at the end of their life.

Apreva Hospice understands that these spiritual practices can, and should be, honored. We’re here to accommodate by providing professional, competent, caring, in-home service that maintains sensitivity to these values. 

Personalized Care Informed by Cultural Respect

Care goes beyond medical support. We are prepared to and can help you and your family with the hospice and bereavement journey with sensitivity toward AAPI’s religious, spiritual, cultural, and personal beliefs. This respect extends beyond rites and rituals and into practical care. The Native Hawaiian belief that spiritual essence (mana) is in all parts of the body can, for example, influence feelings about organ donation or cremation. But awareness of this belief informs our good care for a Native Hawaiian in the end stage of life.

The AAPI population is growing. By 2050, AAPI will become nearly 10% of the total United States population. It’s important that they can get the end-of-life care they need. Our staff ensures that everyone in our care, their family, and their loved ones are treated with respect. 

Some Eastern philosophies view death as part of a cycle in which a loved one’s passage serves as a reminder to celebrate the miracle of life. Our team celebrates the lives of the people we care for, and what makes each of them unique. We’re proud to join this month’s celebration of Asian and Pacific Islander American Heritage Month. We invite interested AAPI Americans to learn about our hospice and in-home services, confident their culture and traditions will be honored.

Close up of hospital sign

On National Hospital Week and Every Week, We Thank You!

By: Anonymous

We invite all community members to join us to recognize National Hospital Week, May 8 to May 14, 2022. Here’s more about this yearly observance and how we honor it at Apreva Hospice.

What Is National Hospital Week?

National Hospital Week is observed every year during the week that includes May 12, Florence Nightingale’s birthday. Florence Nightingale is best known for founding modern professional nursing and demonstrating the importance of nurses and their roles in the healthcare community.

Established in 1953 by the American Hospital Association, National Hospital Week highlights and recognizes hospitals and healthcare workers and the many innovative ways they support their communities.

Thank You For All You Do

Our team understands how challenging and demanding the hospital setting can be. We want to thank physicians, nurses, social workers, discharge planners, aides, and all other clinical staff members who have supported and cared for our patients and communities over the past year, especially given the unique ongoing challenges presented by the COVID-19 pandemic. Your hard work, long hours, and dedication to your communities have helped improve the quality of care for thousands of people in need.

Partnering With Hospice Care

As a leading hospice treatment provider, Apreva Hospice extends extra thanks to hospitals that partner with hospice providers. Your care and services have dramatically improved the quality of life for terminally ill patients and their families. In addition, you have given our team the opportunity to help these families save on hospital-related costs and deliver highly personalized care that helps them fulfill their loved ones’ final wishes.

We look forward to continuing our relationships with hospitals that partner with hospice treatment providers and are confident that together we can handle any unforeseen challenges that may come our way. In honor of National Hospital Week, thank you.

Elderly stroke patient and their caregiver

Hospice Eligibility for Stroke Patients

Some of the most common misconceptions about hospice care involve when it’s appropriate for a patient to elect hospice services and what diagnoses qualify a patient for hospice. People often assume hospice is only for cancer patients, but that is simply not true. You may be surprised to learn that stroke patients also qualify for hospice services.

What is a Stroke?

Strokes are the number five cause of death and a leading cause if disability in the United States. A stroke is defined as a disease that impacts the arteries leading to and within the brain. It occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or ruptures. When this happens, part of the brain cannot get the blood and oxygen it needs, causing it and brain cells to die.

Stroke Warning Signs

The American Stroke Association uses F.A.S.T to help us identify warning signs of a stroke.

F = Face Drooping

If one side of the face is drooping or numb, this can be a common sign of a stroke. One way to help to determine this is by asking the person to smile. If their smile is uneven, that is an indication of face drooping caused by a stroke.

A = Arm Weakness

Another sign can be if one arm feels weak or numb. Ask the person to raise both their arms. If one arm drifts downward, it could be a sign of a stroke.

S = Speech Difficulty

Slurred speech is a third sign of a stroke.

T = Time to Call 911

If someone is showing these three warning signs of a stroke, call 911 immediately.

Other Signs and Symptoms

Other signs and symptoms of a stroke can include:

Stroke Risk Factors

Given the danger of strokes, it’s important to understand the different risk factors, including both those within and out of your control.

Risk Factors You Can Control

Some risk factors of stroke are within your control. These can include:

Risk Factors Beyond Your Control

As with anything else, some stroke risk factors are beyond your control. These can include:

Hospice Qualifiers

Hospice can benefit patients who are in the terminal stages of a stroke. The following criteria could be indicators that it may be a good time to consider the additional support of hospice.

If you are still unsure if your loved one qualifies for hospice, or if you have any questions about hospice for stroke patients, please don’t hesitate to contact us.

National Volunteer Month

Volunteers are an essential part of the hospice care team. The difference they make for our patients and their families is immeasurable. Whether it’s through direct care or administrative work behind the scenes, there are countless ways a hospice volunteer can help.

We are beyond grateful for the incredible people who volunteer their time and talents to make a positive difference in our patients’ lives. In honor of National Volunteer Month, we’d like to recognize just a few of them. We asked our volunteers to share what made them decide to be a hospice volunteer and what they find most rewarding about their experience.

Dennis

Hospice of the Midwest Volunteer – We Honor Veterans Program

Dennis

“On September 10, 2018, Mr. Kelly Gafkjen, Chaplain, Hospice of the Midwest, was a guest speaker at our Urbandale-Johnston Veterans of Foreign Wars monthly meeting. Kelly was on a mission seeking veterans to talk to veterans in local hospice care in their homes or hospice facilities.  Many veterans in hospice would like to share their life and military experiences, but feel only a fellow veteran can associate with their feelings. At the conclusion of his presentation, Kelly asked that we consider volunteering, receive some minimal training, and agree to talk to veterans who are seeking fellow veterans to talk to.  After our meeting concluded, a number of us discussed the information presented by Kelly, and three of us thought this was right in line with our VFW mission of “Veterans helping Veterans”.  Contact was made with Kelley and the three of us started our training at the Fall Training Session September 27, 2018 , conducted by Kelley and Taylor Schneider.  By the end of October we had finished our training and were waiting for our first assigned veteran. Under the guidance of Taylor I was introduced to my first veteran during a pinning ceremony on November, 30, 2018.  Since then I have had the privilege of meeting and sharing both civilian  and military experiences with 9 veterans of WW II, Korea, Vietnam and the Cold War eras.  Every veteran, whether Army, Air Force, Navy or Marine, were all comrades and had their own unique and fascinating stories to tell. Some sad, some humorous, but all seemed willing to share with enthusiasm. I so much enjoyed visiting with these men, and I only hope they felt the  same comradery that I felt while in their presence.  I will miss these veterans but look forward to meeting my next comrade.”

Kendall and Ashley

Premier Hospice Volunteers

Ashley and Kendall

“Kendall and I (Ashley) love volunteering for Premier Hospice! We started in 2019 and volunteer weekly. Kendall states that he enjoys working in an office setting and learning new skills. I have been working with Kendall through the Medicaid Waiver program for almost 5 years. Seeing Kendall get to experience a work-type setting and learn new skills has been very rewarding. Nikki is a lot of fun to work with and always makes us feel appreciated!”

Arav and Anishka

Grane Hospice Volunteers

Arav and Anishka

“We started volunteering for a local hospice during the pandemic (2020). We stumbled upon the opportunity from an email our mom received asking for donations of homemade casseroles and cards for hospice patients and their families. At first, it started by making occasional cards and casseroles, and then it turned into a routine every other week activity. This evolved into helping other hospices including including Grane Hospice. We have made homemade cards and even have given a virtual concert for the patients at Grane Hospice. We feel grateful to be able to give back to others in need even during a worldwide pandemic. It shows no matter what the circumstances, we can help others in our community. All this volunteer work has inspired us to create our own non-profit group called Rays of Sunshine, benefiting local hospices. We hope to expand and help even more local hospices in the future.”

Daniel

CompassionCare Hospice Volunteer

Daniel

“Coming from a family where both parents were in the medical field, I have had an interest in medicine ever since I can remember. In the pursuit of getting involved with medical volunteering opportunities, I wanted to commit to something that would provide meaningful experiences in vulnerable people’s lives, as well as my own. Although my patients’ physical bodies are failing them, they still have great wisdom to impart when given the chance to share and be heard. Many times, I leave the local assisted living facility with an enlightened perspective that I believe will serve me well in the career I am aspiring to have. From hearing first-person stories of World War II experiences to celebrating 96 years of living, there is always a window for valuable learning opportunities when I have the chance to spend time with these folks whom I now consider my friends.”

Joan

AT Home Care and Hospice

Joan

“I Prayed about being a Hospice Volunteer and this is how the Lord is using My ability as a Hairdresser, to bring Comfort and Joy to the Patients. The most rewarding aspect is seeing the Happiness in the Faces of the Patients and their Families. Working with Them is a Blessing to Me.”

Virginia and Flynn

Grane Hospice Volunteers

“Being a hospice volunteer is about having a passion and love for helping others. No, I don’t physically help them but the most rewarding part about volunteering with my dog, Flynn, is seeing the joy it brings to residents. Residents look forward to our visits and remember us from week to week, allowing special connections to be made. I’m thankful for the opportunity Flynn and I have to give our time and make people smile.”

Kennedi and Ernest

Hospice of North Alabama Volunteers

Kennedi and Ernest

Kennedi and Ernest – graduate level social work students with Alabama A&M University and the University of Alabama – are student volunteers with Hospice of North Alabama in Huntsville. They sit with patients to provide caregiver respite. Hospice volunteer work allows students to garner a strong understanding of how social workers broker services within a healthcare agency as well as how to coordinate with various other healthcare and social service agencies.

Ernest states “I have learned that the process of dying and bereavement is as diverse as the families we serve. The first step of serving this population is engaging the patient and/or caregivers on what they want this time in their lives to be like—no two answers are the same.”

Along with the home environment, they also work with residential care communities to provide comfort and support. This gives them experience working with diverse community types and medical care needs.

Kennedi states “The things I’ve learned while interning at Hospice of North Alabama have prepared me to be a more caring and competent social worker. The compassion and kindness that HNA shows to the patients has been extended to me from the very beginning, and I’m so grateful. This has been the greatest experience of service I have committed myself to.” Ernest agrees, adding: “Knowing that you have provided support to a patient and/or their family in this transition period is rewarding. Establishing the trust that fosters comfort and emotional resiliency is an experience that will give volunteers a unique understanding of how health care best serves patients in all life stages.”

Choi-ha

Premier Hospice Volunteer

“My internship and volunteering experience with Premier Hospice was meaningful and fulfilled my longstanding desire of working with end-of-life services to clients and their families. 

I enjoyed working with a well-resourced team that included a chaplain, bereavement coordinator, social workers, liaisons, nurses, a doctor, and a volunteer coordinator. Each of them brought to bear their own particular skillset, and we all collaborated to make our clients’ end of life as comfortable and dignified as possible. 

Besides teamwork, I enjoyed, I enjoyed visiting with my client once a week. My primary role was to support and strengthen the care providers so that they might function better.

I also enjoyed supporting other team members by making caring calls to clients or their families. It was amazing how much comfort and reassurance I could bring to them through the calling service. My participation in the online bereavement group was my gain in the understanding and knowledge of the process in group work, particularly for grieving families. 

Through my time with Premier Hospice, I have grown to better appreciate the important role of leadership in the hospice setting. The internship was profitable to my professional growth and development.”

Katie

Premier Hospice Volunteer

Katie

“I volunteer with hospice to facilitate new transitions. In January 2020, I completed the training to become an End-of-Life Doula in New York City. In my move to Indianapolis, it was important for me to find a strong hospice program where I could be actively involved in the moments of life and death with others.

I volunteer because dying is an important cycle in every community. It is never easy to participate in the dying process, it pulls at every piece of your being. But there is nothing more rewarding than helping a patient or caregiver smile again while recalling a significant life moment. There is nothing more rewarding when the world feels burdensome, to help others find peace even for a single second.”

Thank You, Volunteers!

Thank you to these incredible individuals – and to all the volunteers on our team – for all you do for our patients and their families. You are amazing!

Interested in learning more about volunteer opportunities at Apreva Hospice? We’d love to have you on our team! Learn more and apply here.

Senior woman drinking water with shaking hands

Parkinson’s Awareness

By: Dr. Laura Mantine

Parkinson’s disease (PD) is caused by the loss of dopamine-producing nerve cells within the brain. The loss of dopamine causes symptoms like stiffness, slow movements, balance problems, and depression. There are certain specific motor symptoms that accompany Parkinson’s disease. A resting tremor happens when a body part, usually a hand or foot, shakes slightly when a person is not using it. Bradykinesia is when movements are extremely slow, and patients may have freezing episodes which are temporary, involuntary periods where a person is unable to move. A PD patient may also experience changes in speech, smaller handwriting due to difficulties performing repetitive motions, and a “masked” face due to a loss of facial expression. Patients are also at an increased risk of falls from a combination of poor balance and severe stiffness. A PD patient may develop difficulty swallowing which can lead to weight loss, malnutrition, dehydration, and pneumonia.

There are also non-motor symptoms that are present in Parkinson’s disease. Parkinson’s dementia is a significant, permanent decline in attention, memory, and problem-solving that impairs daily life. A patient may develop hallucinations or delusions throughout their disease course which can lead to increased caregiver stress. Patients may also suffer from severe constipation, urinary problems, and sleep disorders that affect their quality of life.

A Progressive Disease

As a progressive disease, Parkinson’s disease symptoms will slowly worsen over time. While PD affects people in unique ways, there are typical patterns of progression, defined by five stages. In stage 1 and stage 2 of Parkinson’s, patients may experience mild shaking and stiffness. As the disease advances into stages 3 and 4, loss of balance and slowness of movement begin to impair daily functioning. Stage 5 is the final, most debilitating stage of PD. In this stage, patients are wheelchair- or bedbound and require 24-hour nursing care. Patients are said to have end-stage Parkinson’s disease at stages 4 and 5 of the disease. In end-stage Parkinson’s disease, symptoms are so severe that medication stops working well, and patients require full-time caregiver assistance. Eventually, end-stage PD patients become candidates for hospice care, a service that focuses on easing symptoms and improving comfort at the end of life.

Hospice Eligibility

There are no formal PD eligibility guidelines for determining when a hospice referral should be made, and there is no definite timeline when it comes to the final stages of Parkinson’s disease. However, hospice care is available to patients who are expected to live six months or less. Doctors and hospice agencies will consider factors relevant to PD like a patient’s history of falls, hospitalizations, withdrawal from activities, inability to perform self-care, and lack of benefit from medication. There are very general hospice guidelines intended to cover a broad-spectrum of neurological disorders. The guidelines for neurological illnesses state that patients must meet one of the following to be eligible for hospice: critically impaired breathing or rapid disease progression in the past year.

Critically impaired breathing is unlikely to be applicable in Parkinson’s disease. Primary respiratory problems are not typical in advanced PD. The second criterion, evidence of rapid disease progression in the prior year, tends to be more useful for patients with end-stage PD. A rapid disease progression means that patients are bedridden, have unintelligible speech, require a modified diet, and need major assistance with activities of daily living. Nutritional impairment is common in end-stage PD. Patients are unable to maintain sufficient oral intake and experience weight loss and dehydration. Life-threatening complications that may occur in end-stage PD include recurrent aspiration pneumonia and pressure ulcers of the skin.

Hospice for Parkinson’s Patients

Hospice care is an extra layer of support to help care for loved ones with end-stage Parkinson’s disease. The goal of hospice care is to optimize comfort and ease physical, emotional, and mental suffering during the dying process. Members of a hospice care team include a doctor, nurse, social worker, and home health aide. Most patients with PD die from the same diseases such as heart disease, stroke, and cancer, that others do. As such, hospice care may be considered even before a patient with PD reaches the end stages of their disease. Deciding when it is time to enter hospice care can be a difficult decision for a person and their loved ones. However, being admitted to hospice can ensure a person and their caregivers have access to a variety of services that are needed.

References:

“Eligibility for End-Stage Parkinson’s Disease Hospice Care.” By Colleen Doherty, MD. Published on October 24, 2021. Medically reviewed by Isaac O. Opole, MD, PhD. https://www.verywellhealth.com.

“The Role of Hospice in Parkinson’s.” Parkinson’s Foundation. 2018. https://www.parkinson.org.