Ascend Health Blog

We often avoid conversations about hospice, but the one thing we keep hearing from families is, “we wish we had started hospice care sooner.” It’s easy to understand why we hear that. Hospice isn’t for the last few days, it’s for the last months - six months, and can even be recertified for additional periods of time.

When Is It Time To Consider Hospice Care Or To Transition From Palliative Care To Hospice Care?

What Aggravates COPD Symptoms? COPD is a lung disease that obstructs airflow and makes it hard to breathe. If you are coping with COPD, then you already know that. But did you know that it is progressive and gets worse over time? It’s hard to cope with not being able to breathe well. You can’t just decide not to panic, or not to have an anxiety attack. Unfortunately, that stress is also a trigger to making it worse. One of the best things you can do is to understand COPD and what may aggravate the symptoms. Here are some common triggers that frequently aggravate COPD symptoms: Infections: Viral and bacterial respiratory infections can trigger exacerbations of COPD. Common respiratory infections include the flu, COVID, RSV and pneumonia. Weather Changes: This time of year cold air can aggravate COPD. Cold, dry air can irritate the airways and make it harder to breathe. Smoking: The primary cause of COPD is smoking cigarettes. Continuing to smoke is the biggest thing you can do to aggravate COPD and make it progress quicker. Indoor Irritants: Indoor irritants like fumes from cleaning products, and mold can aggravate COPD. Avoid these and make sure you have good ventilation if you are coping with COPD. Taking Medications Incorrectly: Create a system to make sure your loved one gets the right dosages on the right schedule. Taking medications improperly is not following your treatment plan, and that can make symptoms worse. Poor Inhaler Technique : Inhalers are as important as any other medications. Can your loved one press the inhaler and coordinate inhaling it properly? Or is the medication just hitting the back of their throat? Many inhalants may be available for a nebulizer so they can just relax and breathe, ask your doctor. Comorbidities: Other conditions, like heart failure or asthma can complicate COPD. Consider the big picture and discuss your concerns with your doctor. Occupational Exposures: People working in certain industries, such as construction or manufacturing, may find COPD triggers at work. Workplace exposure to dust, chemicals, or fumes may aggravate COPD. Low Physical Activity: Inactivity and a sedentary lifestyle can weaken respiratory muscles and reduce lung function. Regular exercise is important for maintaining lung health in individuals with COPD. Gastroesophageal Reflux Disease (GERD): GERD is a more serious form of acid reflux. It’s a condition where stomach acid flows back into the esophagus to potentially aggravate COPD symptoms. It is possible for stomach acid to reach the lungs, leading to irritation and exacerbation of respiratory symptoms. Air Pollution: Exposure to air pollutants like dust, smog or exhaust fumes can aggravate COPD symptoms. That includes indoor fumes and smoke from cleaning products, cooking and heating. Managing COPD well will involve a combination of lifestyle changes, medication, and sometimes supplemental oxygen therapy . Those with COPD should work closely with their healthcare professionals to create a comprehensive management plan tailored to their specific needs and triggers. Ascend Hospice is experienced in managing COPD and will work with your physicians to create a care plan customized to your specific needs in your specific living environment. Our highly skilled team of caregivers includes both nurses and physicians trained to manage and treat COPD. Controlling symptoms, stress and anxiety will be effective in caring for a loved one coping with COPD . To learn how Ascend can improve quality of life, simply click here for peace of mind .

Discussing hospice care with your doctor is an important and often emotionally charged conversation. Hospice care is typically considered when curative measures have been ineffective and are unlikely to bring about a cure. Hospice helps those coping with serious illness manage symptoms and focus on finding as much comfort as possible for whatever time remains. Here are a few tips to approach this discussion with your doctor: 1 - Schedule the right kind of appointment: Schedule an appointment with your doctor that allows enough time for a real conversation. Ensure you have a private and quiet space to discuss sensitive matters. 2 - Bring Someone for Support: You may feel overwhelmed during the conversation, so having a trusted friend or family member with you can provide emotional support and help you remember the details of the discussion. 3 - Be Open and Honest: Start the conversation by expressing your feelings and concerns honestly. You can say something like, "I've been thinking about my condition and the options available. I'd like to discuss the possibility of hospice care." 4 - Come Prepared: Come prepared knowing as much about hospice care as you can, such as how it works, what services are provided, where it can be administered (at home, in a facility), and what to expect. Read online or contact us to learn more. Do not assume your provider is knowledgeable about hospice care, doctors are trained to be curative. 5 - Listen to Your Doctor: Your doctor will advise about hospice and how appropriate it is for your situation. Pay attention to their recommendations and explanations. 6 - Share Your Goals and Wishes: Share your personal goals for care, whether it's to manage symptoms, be at home, or to have more quality time with loved ones. Your doctor can help align these goals with the hospice services available. 7 - Include Your Family: If you have family members involved in your care, include them in the conversation. Discuss their concerns and preferences as well. 8 - Consider the hospice team roles: Your hospice care team may include nurses, social workers, chaplains, and volunteers. Consider how their roles might help your situation and voice how they might help you. 9 - Be Ready to Review Any Required Documentation: Your doctor may make a formal referral to a hospice program. Make sure you understand the process and be ready to review any paperwork he may suggest. 10 - Understand Who Pays For Hospice: Understand who pays for hospice care . If you are on Medicare, it’s a Medicare benefit or your insurance may pay for it. 11 - Make an Informed Decision: After discussing everything in detail, take your time to consider your options. Discuss the decision with your family, loved ones, and other healthcare professionals if necessary. Remember that the decision to choose hospice care is your personal choice. It should support your values and goals for care. Your doctor's role is to provide information and guidance to help you make an informed decision that best meets your needs and wishes. Learn more here or contact us to learn more.

Alzheimer’s is a devastating, progressive disease that destroys memory and other important mental functions. Though memory loss and confusion are the main symptoms, depression and anxiety are also very real struggles for those living with Alzheimer’s. In fact, experts estimate that up to 40 percent of people with Alzheimer's disease suffer from significant depression. It is not surprising that depression is associated with Alzheimer's as those who live with this disease face the realization of the very real toll this illness will have on their lives. If you are caring for a loved one with this difficult disease, at some point you will likely have to deal with the anxiety and depression of Alzheimer's. But there are many things you can do to help someone who has Alzheimer depression. According to the Alzheimer’s Association , identifying depression in someone with Alzheimer's can be difficult, since dementia can cause some of the same symptoms. Signs of depression can include: apathy, social withdrawal, loss of interest in hobbies or activities, trouble concentrating and impaired thinking. If you think your loved one may be suffering from depression here are some ways to help: Let Them Contribute. Help your loved one feel appreciated and respected. Find ways they can still contribute and thank them for their efforts. Praising them can help lift their spirits and make them feel better. Let Them Know They Are Loved. Those living with Alzheimer's face losing the person they once were. Let them know that they are loved, respected and an important part of the family. Help them realize that their value to those who love them will never be diminished. Let Them Know They Are Not Alone. Provide reassurance that they will never be abandoned or face this disease alone. They have support from family and their medical team who will remain by their side with expert care. Reassure them that they are safe and protected. Educate Yourself. It’s important to learn as much as you can about Alzheimer's. Understanding the disease progression will help you anticipate challenges, reduce fear of the unknown, and help you make informed decisions. Establish a Daily Routine. Maintaining a regular routine can provide a sense of stability and predictability, which can help reduce anxiety for patients and caregivers. Create A Smoothing Environment. Create a pleasant environment that uplifts their spirit and soothes fear or anxiety. Make sure to include things they love and are familiar with. Try to avoid loud noises or over stimulation. Think calm, quiet and pampering. Practice Mindfulness and Relaxation Techniques. Techniques like deep breathing, progressive muscle relaxation, and meditation can help manage stress and anxiety. Be Aware of Triggers. Think ahead and avoid situations that might trigger anxiety or distress for the patient. Encourage Activities. Find activities that can divert their attention like music, art, crafting or taking a walk. Manage Expectations. Alzheimer's is a progressive disease and certain changes in behavior and memory are part of the condition. Understanding that and managing your expectations will reduce frustration and disappointment. WHEN TO SEE A DOCTOR As a caregiver, if you see signs of depression, discuss them with your loved one’s physician. Proper diagnosis and treatment can help improve their quality of life. The American Academy of Family Physicians (AAFP) recommends that adults be screened for depression. Your loved one’s physician may prescribe medication to help control symptoms and improve their emotional health and wellbeing. Medications can be helpful but it will be important for you as their caregiver to understand side effects and to ensure they are taken as prescribed. ACCEPT SUPPORT AND PRACTICE SELF CARE When caring for a loved one with Alzheimer’s it's important to ensure your own wellbeing. This disease plays emotional havoc on all those who love the person living with Alzheimer's but it is the family caregiver who will bear the most of the burden. As the disease progresses so will your responsibilities to your loved one. It’s important that you don’t sacrifice your own wellbeing and health. Accepting support will be critical in ensuring your ability to continue to provide the best care for your loved one. Understanding when to seek an extra layer of support can help you ensure your ability to continue to provide the best care possible for your loved one. When to gain support for Alzheimer’s caregiving is a personal decision and different for every family. But Alzheimer’s is a progressive disease where symptoms get much worse over time. As your loved one’s disease progresses into late-stage Alzheimer’s it will become more challenging to manage their needs, ensure their comfort and protect your own well-being without extra support. Our blog 7 Signs It’s Time For Extra Support shares insights on when discussing hospice or palliative care makes sense Ascend Health offers specialized care for those living with end-stage Alzheimer’s. Our supportive team focuses on improving quality of life and easing the distressing burdens of Alzheimer’s. Learn more about how we can help bring comfort and support by reaching out to a member of our compassionate team.

When diagnosed with a life threatening illness our world shifts. Time becomes thought of ‘before’ the illness to ‘after the news.’ Your world feels as if it’s been thrown off kilter, and spinning out of control. You may feel completely lost, like swimming in a deep ocean where you can’t see the shore. But there are ways to learn to cope with the emotional distress, regain a sense of control and preserve your quality of life. It’s important to realize that you are not powerless. There are ways to help you cope with the stress, fear, hopelessness, anger and sense of having no control over your life. Learning coping techniques can help you navigate these difficult emotions and find a way forward. In this blog we share techniques for coping with a life limiting illness. Understand Your Emotions. Many of us are taught that emotions like fear, anger, and depression are a negative reflection on ourselves and should be avoided. But when living with a life threatening illness these emotions are normal and even expected. Understanding and acknowledging your emotions, rather than denying them, will be important to your ability to live better with your illness. By accepting your emotions you can learn coping techniques to help move past these unsettling feelings, where repressing them will simply allow them to build and potentially become overwhelming. Allowing yourself to feel what you feel, exploring why you feel this way will let the emotion pass. Talk to your physician about coping techniques like meditation, or taking a deep breath and becoming grounded in what’s around you - what you see, hear, smell, taste, and touch. Learning that you can overcome difficult emotions will help you feel less overwhelmed by them next time. Accept The Uncertainty. When you’re diagnosed with a potentially life-limiting illness you feel like you are living with a lot of uncertainty. It is so easy to get stuck focusing on the “what if’s”. Learning to know how to deal with the uncertainty of your future can feel impossible and overwhelming. How do you possibly move forward when worrying about what might happen? You move ​​forward by focusing on today, on the now. Worrying about what might happen won’t give you more predictability about your future or any more control. But it will most certainly rob you of today and the good things you are still able to enjoy. Focus on the present. Let Others Uplift You. Living with a life-limiting illness can feel isolating. It’s easy to feel like no one will really understand because they are not living it. You should not carry this burden alone. Social support helps us feel less helpless in general and especially when battling illness. There is an abundance of evidence suggesting social support is linked with lower depression 1 , lower anxiety, and lower hopelessness levels among depressed patients 2 . Social support enhances quality of life and provides a buffer against adverse life events. Find a few, or even one, family member or friend you can confide in and lean on. Let others uplift you during this very difficult journey. Be Gentle To Yourself. Our self image can easily crumble when dealing with a serious illness. Your image of yourself may change. You may have considered yourself strong, brave, and fearless before your diagnosis. You may feel you are not a whole person anymore, but have become lessened by the conditions of your illness. Realize that you are learning to deal with a new normal, one that may have been completely out of the blue and unexpected. Our character is built from our past experiences, challenges and adversities that we’ve handled in life. It becomes our roadmap for life. But this is all new, it is like nothing you have experienced before. It will take time to learn to adjust, so be gentle with yourself if you feel you are not as strong or brave or fearless as you were. You will learn to live with your illness and adjust to your new normal, you will find your way back to yourself. Find New Joy. Reconnecting to what brings you meaning, purpose and joy will also help you feel less defined by your illness. Embracing what gives your life meaning will help you regain the sense of self and purpose that you may feel you have lost. If you cannot enjoy some of the activities you once loved because of your medical condition, you can still find pastimes that will enrich your life. Explore new hobbies or new experiences - nature, the arts, crafting, writing, baking, or even volunteering. Find something that will nourish your soul. When life expectancy becomes limited, our hospice team offers comfort and care at a most sensitive time. We encourage patients to strengthen connections, have important conversations and embrace the time spent with loved ones during the transition to this important stage. Our personalized holistic approach to hospice care includes relief of pain and symptoms, as well as emotional and spiritual support for patients and their loved ones. Coping with a life threatening illness may be difficult, but you don’t have to do it alone. We hope these techniques will help, and remember, reaching out for help can make a world of difference. 1 - Social support and protection from depression: systematic review of current findings in Western countries. Published online by Cambridge University Press: 02 January 2018 2 - The Importance of Social Support in Mental Health, BENSON MUNYAN, PH.D., July 16, 2021

If you’ve lost a parent it's normal to feel apprehension and even dread as holidays like Father’s Day approach. That first Father’s Day without your dad can intensify your loss. If dad was a grounding force in your life you can feel untethered and isolated. You’re likely to feel unsure how to navigate a day that’s dedicated to celebrating someone no longer with you.There’s no magic way to make this day easy. But we hope sharing 5 tips on how to survive can help you feel empowered to find your way. Feel Fully. It’s OK to let yourself fully experience what you are feeling. Feelings of sadness, anger, wanting and pain are normal and expected. Don’t judge yourself or feel like you’re letting anyone down. Give yourself permission to feel the way you do. If you can sit with these feelings, acknowledge them and accept them, then you will have more power to be comfortable with these very human emotions. Celebrate A Positive Male Role Model. Celebrating another male role model in your life can bring you comfort and help you feel less untethered. Celebrating what someone else has meant to you can bring joy and remind you that love and support still surrounds you. Focus On Happy Memories. Memories are where your father can continue to live long after his passing. Memories of happier times remind us of the joy and love he had in his life. Memories can also help us process loss. Remembrance can help you refocus on gratitude for the time you had with him in your life. Gratitude is powerful. When you are able to look with gratitude on the wonderful memories of the past and the coming memories of tomorrow with others you love, you can begin to heal. Spend Time With Others . Spending time with others who loved him can make you feel his presence. Ask others to share their favorite memories or stories of your dad. You may learn new things about your father’s life and gain new memories to hold close. Seeing what he meant to others can help you realize he is not really gone, he also lives in the hearts and minds of all of you. Distract Yourself. It’s OK to completely skip Father’s Day. When nothing else feels right, plan an activity to distract yourself. Plan something that will help occupy your mind and help you escape the day. Go out of town to explore someplace new, plan an adventure you have never done before, treat yourself to a staycation at a fancy hotel, pamper yourself. So much about Father’s Day can be a sensory overload - places, sounds, smells that trigger memories, and all those social media posts of happy family celebrations. If you are simply not ready to face Father’s Day, escaping somewhere new can help. Your first Father’s Day without your dad will not be easy. But it can feel empowering and then hopeful when you are able to navigate the day. We hope these suggestions help you find what peace and comfort you can. If you also lost your mom, then you may find our blog How To Survive Mother’s Day insightful. Remember that grief is a personal journey; allow yourself to travel at your own pace.

The second Sunday in May, usually a time of celebration and family, can be the opposite for someone who has recently lost their mom. Mother’s Day can be difficult when our mother is no longer with us. The first Mother’s Day without your mom can seem almost impossible to navigate. Emotions can be raw and messy, and it may feel overwhelming to consider how to get through the day. Surviving the first Mother’s Day without your mother will not be easy. Even though this day will never feel the same, we hope these tips will help you feel empowered to navigate the day in a way that works for you. Acknowledge your feelings. You feel what you feel. Don’t judge your emotions. Don’t let the expectations of others or your own expectations for the day dictate your emotions. Trying to be strong and hide your true feelings is not healthy. Grief is a personal journey, travel it at your own pace. It’s OK to feel sad, angry, and overwhelmed. It’s also OK to seek support. While anxiety and sadness are normal reactions to loss, seek help if they seem severe, disabling or are impacting your key roles at home, work, or school. Write her a Mother’s Day card. Sharing how you feel about your mother and what she meant to you can help you find comfort and refocus on being grateful for the time you did have together. Writing her a card will give you the opportunity to say again the things you might have said a hundred times or wished you had said one more time. Remember, her spirit lives within your memory of her, the words you write will prove she, in a way, is still with you. Reclaim the day for you. Whether you are a mother yourself or not, reclaim and celebrate yourself or another significant female you love. Focus on the present moment with those you love. Send yourself flowers, eat way too much candy, do something that you love that lifts your spirits. Make this day about self-love, your mom would not want you to face this day with sadness and pain. Find the strength she instilled in you and the love she had and celebrate someone special, you. She would want you to have a great day. Surround yourself with loved ones. Let others sweep you up in their love for you. Being in the company of others can help you feel less alone or isolated. It could be relatives who also loved your mom, allowing you to celebrate her memory. Or you could spend time with friends doing something you enjoy together completely unrelated to Mother’s Day. Spending the day with others can help uplift you from feeling the heavy impact of loss and help distract you from the meaning of the day. It’s OK To Do Nothing. If any type of activity or celebration seems like it might be too much, then it’s OK to say No. It’s OK to simply skip Mother’s Day. If you decide to ignore the day, then be careful not to stumble upon reminders. It may be helpful to stay off social media which is likely to be filled with posts of happy family celebrations. Find something you can get lost in, like going to the movies, hiking in the park, attending a local sports event, or even taking on a task like organizing your closets. As the second Sunday in May approaches, it will help to plan how you will manage the day. The only real rules are to be kind to yourself and to set no expectations. You will get through it; the day will pass, and you will come out the other side knowing that you survived – and that will feel powerful. Ascend offers help and comfort to those grieving the loss of a loved one through grief services, programs, and annual tribute events. Reach out to the Ascend location nearest to you for additional information.

April 16th is National Healthcare Decisions Day (NHDD). National Healthcare Decisions Day exists to inspire, educate and empower the public and providers about the importance of advance care planning. It is a day dedicated to helping everyone talk about and plan for important healthcare decisions. These conversations are important for many reasons, there may come a time when you are unable to speak for yourself and become unable to make important decisions regarding your healthcare wishes. Not having your wishes known puts a difficult and emotional strain on your loved ones as they try to decide what you would have wanted. Physicians are left in the dark with no guidance on how to respect your wishes. An important topic that Ascend Hospice encourages you to include in your planning are conversations on what would matter to you if you are living with a serious life-limiting illness. Sharing your wishes, preferences and goals with your loved ones and healthcare providers will help ensure you receive the care you want. Here’s 5 questions to consider when living with a serious illness 1. How much medical treatment am I willing to undertake to extend my life? Consider which is more important, more time or more quality of life. Do you want physicians to do everything possible to extend your life even at the cost of quality of life? 2. Who do I want to be involved in my medical decisions? Consider who you want to be involved in medical decisions. It will be important to name someone who can make medical decisions for you, if you cannot in the future. Having someone close to you travel this journey with you will provide much needed comfort, support and even advocacy to ensure your wishes. But remember, what you share and what your healthcare team shares is up to you. If a loved one accompanies you on doctor visits let your providers know what they can and cannot speak about in front of them. 3. How do I want others to treat me? Often people decide not to share their serious illness with others because they do not want to be treated differently. It can help to be honest with others and share how you want to be treated. Do you prefer not making your illness the center of conversation? Do you feel people care more when they ask about how you are doing? Do you want others to give advice, information and share resources? Do you simply want everyone to stop sharing what they found on Google? Do you want people praying for you? Do you prefer to be treated as if you are not living with a serious illness or do you find comfort in others' concerns, expressions of love and offers of support? 4. What do you want for the future? Think about what you do want, and what you do not want. Examples might include: I want to be comfortable and free of pain, I want to be surrounded by loved ones, I want to focus on quality of life, I want to be at peace spiritually, I want to pass at home. Also think about what you do not want to happen. Examples might include: I don’t want to pass in a hospital, I don’t want to be in the ICU, I don’t want aggressive treatment, I don’t want to keep going to the ER, I don’t want to be in a lot of pain, I don’t want my family burdened by decisions. 5. What are your sources of hope, strength, comfort and peace? Living with serious illness is also an emotional journey, especially at the end of life. At the end of life people often reflect. You may have questions about the meaning of life and begin to think about your spiritual needs in new ways. Spiritual support can greatly enhance your wellbeing. Making your wishes known is important and empowering. It is important to educate yourself on available healthcare options while you are living with a serious illness. But it's also important, even if you are currently healthy, to consider what you would want in the future if you were diagnosed with a serious illness. Planning ahead helps ensure that you or your loved ones won't be tasked with making decisions during a time that is already stressful and unsettling. Many people don’t fully understand options like hospice or palliative care that focus on reducing symptoms and increasing quality of life. Explore our website and care support options to gain insights on choices that can help you live with illness today and help guide your decisions for the future.