What really matters

How we approach healthcare matters.

As healthcare professionals, our job is to reframe how we look at people’s health and treat our patients with their goals in mind. We are intentional in our approaches to put our patient’s goals as an integral component of their care plan. Our challenge is often to reframe how we provide this care, because it breaks from expectations. And, it is constantly evolving.

One of the areas of reframing is in how we look at the end of life, and this is why we do hospice.

Hospice is designed to provide comfort and care for the end-of-life. But, this also means looking at what is meaningful in the first place for our patient. It also means bringing in people that facilitate what is meaningful and how that changes as the individual is on our service.

Hospice is provided for cancer, dementia, cardiac disease, pulmonary disease, renal disease, liver disease, HIV/AIDS, neurological disease, and strokes/coma. It is a service that is provided by a nurse, a chaplain, and a social worker. That’s the basic.

We add in massage therapy, nurses aides, volunteers, physical therapists, occupational therapists, and speech language pathologists.

Patient-directed care means that you lead the process. It also means that you help reframe what it looks like for you.

Pain is a disease

September is Pain Awareness Month.

Understanding chronic pain is critical to how we support our patients on our service.

Join us in our learning:

Pain Awareness Month – International Association for the Study of Pain (IASP) (iasp-pain.org)

September is Pain Awareness Month: Complexity and Progress in Pain Research | National Institute of Neurological Disorders and Stroke (nih.gov)

Pain Awareness Month 2023 – U.S. Pain Foundation (uspainfoundation.org)

What is Psoriasis?

Psoriasis is an immune-mediated disease* (a disease with an unclear cause that is characterized by inflammation caused by dysfunction of the immune system) that causes inflammation in the body. There may be visible signs of inflammation such as raised plaques (plaques may look different for different skin types) and scales on the skin. 

This occurs because the overactive immune system speeds up skin cell growth. Normal skin cells completely grow and shed (fall off) in a month. With psoriasis, skin cells do this in only three or four days. Instead of shedding, the skin cells pile up on the surface of the skin. Some people report that psoriasis plaques itch, burn, and sting. Plaques and scales may appear on any part of the body, although they are commonly found on the elbows, knees, and scalp.

Inflammation caused by psoriasis can impact other organs and tissues in the body. People with psoriasis may also experience other health conditions. One in three people with psoriasis may also develop psoriatic arthritis. Signs of PsA include swelling, stiffness and pain in the joints and areas surrounding the joints. PsA often goes undiagnosed, particularly in its milder forms. However, it’s important to treat PsA early on to help avoid permanent joint damage.

Symptoms often start between ages 15 and 25, but can start at any age. Menwomen, and children of all skin colors can get psoriasis.

From https://www.psoriasis.org/about-psoriasis/

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Aging as an adventure

Aging can have a negative connotation in our culture.

One of the goals we have at Elite is to promote healthy aging. We are intentional in our community work to preserve people’s wishes for independence, their voice in their healthcare plans, and building rehabilitation around their needs. Through home health, palliative care, and hospice, we value and respect aging. Our goal is to join you on your journey.

For information on the best aging strategies, check out:
Dishman, Eric. “Inventing wellness systems for aging in place.” Computer 37.5 (2004): 34-41.

Mitzner, Tracy L., et al. “Self-management of wellness and illness in an aging population.” Reviews of human factors and ergonomics 8.1 (2013): 277-333.

Coughlin, Joseph F., and James Pope. “Innovations in health, wellness, and aging-in-place.” IEEE Engineering in Medicine and Biology Magazine 27.4 (2008): 47-52.

If you are open to a new perspective, check out…

What if your life continued after your death?

Not all cultures look at death in the same way.

Different cultures perspective of death changes the way individuals perceive and process death, and people’s approach to the death and dying process can be very different based on their cultural perspective of life and death.

If you are interested in some interesting articles, check out:

Roberson, Karen, Turenza Smith, and Wanda Davidson. “Understanding Death Rituals.” International Journal of Childbirth Education 33.3 (2018).

Lobar, Sandra L., JoAnne M. Youngblut, and Dorothy Brooten. “Cross-cultural beliefs, ceremonies, and rituals surrounding death of a loved one.” Pediatric nursing 32.1 (2006): 44-50.

Why it is important to talk about your dying wishes

One of the ways we at Elite approach a comprehensive care mentality is that we take time to run through your, as the patient, and your family’s goals of care. Identifying what treatments are important to you, and examining what you are willing to push through in the recovery and repair after those treatments. We call these meetings goals of care.

We are comfortable with understanding that building a care plan around your dying wishes is the only way to serve hospice. So, we work through the Five Wishes (https://www.fivewishes.org/) as part of your hospice journey, and we work with you and your family to create your best experience. We also believe that having a plan is what allows for our patients to live their best life.

Death and Dementia

One of the most common diagnoses we see for hospice care is dementia. The challenge of losing a loved one seems to be magnified when family is also the caregiver, and even more so when your loved one is passing from a disease like dementia.

At Elite, we train in our hospice care with materials from Barbara Karnes, RN, a long-time hospice nurse. Below is a video of a conversation with Barbara on YouTube discussing end of life care in persons with dementia.

Morphine and Hospice

A common myth is that morphine causes death in hospice.

This is incorrect and a misconception of morphine and hospice. Take a look at this video by Barbara Karnes, a hospice expert.

If you still have questions, let us know. We would love to get this discussion going.

Who is Barbara Karnes?

Barbara Karnes, RN Award Winning End of Life Educator, Award Winning Nurse, NHPCO Hospice Innovator Award Winner 2018 & 2015 International Humanitarian Woman of the Year 

While at the bedside of hundreds of people during the dying process, Hospice Pioneer Barbara Karnes noticed that each death was following a near identical script. Each person was going through the stages of death in almost the same manner and most families came to her with similar questions. These realizations led Barbara to sit down and write Gone From My Sight, “The Little Blue Book” that changed the hospice industry.  

Gone From My Sight is the original, and remains the most widely used, patient/family educational booklet on the signs of approaching death. It has been in print continuously since 1985 and has sold over 35 million copies world wide. With its publication and distribution, Barbara created one of the most important tools in the end of life movement today.  

“People don’t understand that there’s a normal, natural way of dying. My materials are written to guide and support anyone who finds themselves addressing end of life situations. The goal is to help people have a positive experience so everyone involved will have a sacred memory to carry with them.” – Barbara Karnes, RN

Learn more at https://bkbooks.com/pages/about-barbara?gclid=EAIaIQobChMIsND48PjI_wIV7CqtBh1BKA8uEAAYASABEgJGk_D_BwE