The mission of this site is to provide information about elder mental health. This page will be a place to learn about end of life care and mental health issues which arise during the dying process for elders and their personal/professional caregivers. A terminal illness may cause many reactions including:
This page will be used to address some of those and other concerns.
HOSPICEINTRODUCTION AND BACKGROUND Within our society dying has historically happened at home. However, this has changed and now most people die in medical institutions(hospital, nursing home, etc.). it is the goal of medical care to cure people - to make us better. There can be a focus on one aspect of a person's life. Hospice care wants to help us to have a dignified death. This approach tends to be more holistic. DEFINITION This is a way to care for people with a terminal illness and also their loved ones. It strives to meet all of an individal's needs:
Hospice also works with loved ones. It enables people with terminal illnesses to make decisions about how and where they want to spend the rest of their lives. GOALS OF CARE The overall goal is to help people to live as comfortably as they can for as long as they live and to help their family/caregivers to live with them. Pain Control This is a major fear of many who are seriously ill. Hospice will attempt to achieve control over pain without impacting level of alterness. Living Life Individuals are helped to achieve physical and emotional comfort in order to concentrate on living. Treating individuals and Their Loved Ones as a Unit An individual's loved ones feel the pain of the terminal illness. Hospice provides relief to caregivers. COMPONENTS OF CARE Physical Needs Hospice tries to help individuals to use their physical abilities as fully as possible. People can be more comfortable with:
Social Needs Seriously ill individuals may not be as active as they used to be but we are all still social beings and hospice can help with:
Emotional Needs Individuals and their families cope with loneliness, isolation and fear. Hospice:
Spiritual Needs Spiritual matters are important for the terminally ill individual and others. Hospice can help:
MEDICARE AND HOSPICE Medicare has a hospice benefit for those who are at home, in a hospital, or a nursing home. The following describes the requirements and characteristics of this benefit. Services are available for cargivers. Requirements to obtain the Medicare Hospice Benefit:
Coverage Does not Include:
Care is provided by a team which may include:
CONTACT/ RESOURCE INFORMATION *MEDICARE 1-800-633-4227(MEDICARE) www.medicare.gov HOSPICE ORGANIZATIONS NATIONAL HOSPICE & PALLIATIVE CARE ORGANIZATION 1-800-658-8898 www.nhpco.org HOSPICE ASSOCIATION OF AMERICA 1-202-546-4759 www.nahc.org/haa Within Mass. HOSPICE & PALLIATIVE CARE FEDERATION OF MASS 800-536-6300 CENTRAL MASSACHUSETTS PARTNERSHIP TO IMPROVE CARE AT THE END OF LIFE www.betterending.org Back to top SPIRITUALITY
We struggle to make meaning of our losses and to comprehend what may feel like senseless tragedy. We may pose what are rich and possibly unanswerable questions as we yearn for explanations. We may find support and healing in the ideas, rituals, and traditions of our faith or philosophy. For others the death of a loved one often moves them to examine, to question, and sometimes to move away from their spiritual beliefs. Bereaved individuals who did not embrace a spiritual belief system or who have withdrawn from a religious doctrine or belief may find themselves urgently seeking answers to existential questions such as:
Many times when a loved one dies, those who grieve for them find themselves angry with God or a Higher power of their understanding. They may:
In the midst of grief there are activities which can bring one comfort and peace. For those who are part of a faith community solace and fellowship may be found in sacred services or gatherings. Members of a congregation or spiritual community may embrace and support the grieved person and that can be nourishing and restorative. For anyone there can be:
Some steps which a grieved individual can take are: Prayer This can be a source of sustenance and provide a sense of connection in a person's life. Even if it has not done so before it may now offer the bereaved peson some strength. Mediation This involves focusing attention inward and encompasses a variety of techniques which assist in developing:
This may incorporate guided imagery and visualization. Ritual This can be a powerful way of finding meaning in loss and also provide a method for connecting physical, mental, emotional, and spiritual expression. Rituals can be healing for both body and soul. They can be symbolic affirmations that a significant change has taken place and enable the bereaved person(s) to create a sense of balance and focus in the midst of overwhelming feelings. They can help us remember love ones in ways which allow for self reflection and to connect with others even as we find the strength and courage to continue on our journey. Forgiveness Many grieving individuals have feelings of guilt, regret, anger, and resentment toward the one who has died or towards themselves. Forgiveness of self and the loved one can serve to release people from the chains which prevent them from healing. Any or all of those may deepen ones sense of spiritual connection.
ADVANCED DIRECTIVES
As a result of the controversy about Terry Schiavo's last days there have been many questions about advanced directives. 1. What is an advanced directive? 2. How would it be used? 3. What are the types of advanced directives? 1. What is an Advanced Directive? -It is a written statement about future medical care by an individual who directs others to follow their choices when that person is unable to communicate.
2. How Would it be Used?Some examples are: A. Resucitation B. Hospitalization C. Feeding Tubes D. Respirators E. Pain Relief F.Dialysis G.Intravenous(IV) Therapy
3. What are the types of Advanced Directives?A. Living Will B. Health Care Proxy(Health Care Power of Attorney) It goes into effect when the person can no longer make decisions A lawyer is not needed for a health care proxy. You(or the person who does this) can change the decision. . C. Durable Power of Attorney Laws in different States sometimes prohibit specific advanced directives. You should check to determine what is allowed in your State. Any advanced directive can be changed or modified. For example, a directive for a DNR can be changed to be full code or vice versa.
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