Hospice of Southern Illinois

Premiere Local Hospice Provider

Planning for YOU: Important End-of-life Conversation Tips

We plan for everything! Let’s take control of our end-of-life conversations for our own peace, comfort and dignity. While our fears may make this conversation uncomfortable to start, having conversations about healthcare is essential! Remember, talking about your end-of-life wishes and getting your affairs in order doesn’t bring it closer. Here are a few things end-of-life conversations can do:

  1. Leads to improved quality of life
  2. Ensures your wishes are followed
  3. Provides peace of mind knowing there is a plan in place
  4. Relieves family pressure and stress when you cannot speak for yourself
  5. Enables families to focus on caregiving and reflection rather than crisis

An AARP article gathered these insightful statistics, “How we want to die is the most important and costly conversation Americans aren’t having. Consider these facts:

  • Ninety-two percent of people think it is important to talk about end-of-life wishes with their loved ones, but only 32 percent have done so, according to a 2018 survey by the Conversation Project, which works to promote greater discussion of end-of-life-care.
  • One in 5 said they’ve avoided the subject out of worry about upsetting their loved ones.
  • Ninety-six percent of people 65 and older consider it important to put in writing their wishes for medical care in case of serious illness, but only a quarter have shared such a document with a doctor, a 2017 Kaiser Family Foundation study found.
  • A sizable majority of people say they want to die at home, but 60 percent die in hospitals or institutions.”
Caregiver Conversations Guide

Download our free Caregivers Conversations Booklet, a guide for caregivers and their loved ones. We introduce general health, mental wellness, healthcare options, including comfort care, and advance directives talking points. It’s never too soon to start talking with your family about WISHES YOUR WAY!

Planning for you, NOW!

Lastly, here are a few steps and resources you can consider right now no matter what your age or situation is:

  1. Plan Your Advance Directives, Which Include:
  2. Who should have Advance Directives?
  3. Who can speak for you if you cannot?
  4. You are in charge of your decisions!
Caregiver Conversations Guide

Download our free Caregivers Conversations Booklet, a guide for caregivers and their loved ones. We introduce general health, mental wellness, healthcare options, including comfort care, and advance directives talking points. It’s never too soon to start talking with your family about WISHES YOUR WAY!

Hospice of Southern Illinois' social worker reviewing planning for you with family to ensure peace of mind

Having these conversations with family and friends is an invaluable gift to those you love. Further, sharing where these guides and documents are located is equally as important. The more often you have open and honest discussions, the easier it will be to approach changes or challenges that arise. Preparing for your future healthcare wishes before you need it is smart! Planning all your healthcare wishes, including your end-of-life journey, helps to ensure a more positive experience for health changes that may be ahead. Most importantly, it can lead to a better quality of life overall. If you need assistance planning for end-of-life or need more support caring for someone at the end of their life, call our experienced team today, 1-800-233-1708.

Call Hospice of Southern Illinois to learn more about end-of-life care and hospice services, 800-233-1708. Request a chat.

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Is my dying loved one experiencing depression?

Grief versus Depression in the Hospice Patient

Identifying the difference between normal grief and clinical depression can be a challenging task in the dying patient, but a task that is extremely important. Emotional distress is natural and expected when one is experiencing a serious illness and confronting the end of their life. The differentiation between a normal and appropriate reaction to death and a more serious psychiatric disorder, such as major depression, can be clinically taxing.

patient speaking with social worker about “anticipatory” grief, a normal reaction

When an individual learns that they have received a terminal diagnosis, “preparatory” or “anticipatory” grief is a normal reaction. This is defined as the type of grief that the terminally ill patient has to undergo in order to prepare themselves for their final separation from their world. It is commonly accompanied by withdrawal from family and friends, intermittent sadness, crying, anxiety and deliberating on the past.

This type of grief is a normal, not pathological, life cycle event. These individuals are still able to retain the capacity for pleasure and look forward to items in the near future. They may have passive wishes for death, but there are no intense, persistent suicidal thoughts. Their symptoms often come in waves.

When It’s More Than Grief: Signs of Depression

In contrast to the normal reactions of “preparatory” grief, healthcare professionals categorize major depression differently. For example, there is a persistent flat affect or overwhelming feelings of hopelessness, helplessness, and worthlessness. The patient has little interest in activities that normally brought them pleasure. They often have sleep and appetite disturbances. We do not typically see a disturbed self-esteem and grief together; however, it is quite typical in depression. Individuals with severe major depression may experience an active desire for early death and have persistent, intense suicidal thoughts. They may experience feelings of guilt and have no sense of anything to look forward to in the near future.

Clinically significant depression is likely more common, 25-77% based on the study, in the dying population than in the general public. However, depression is not an inevitable part of the dying process. Therefore, screening for depression should be carried out in all terminally ill patients, as treatment is widely available and typically successful. First and foremost, we must ensure that all uncontrolled symptoms are treated, particularly pain. After these symptoms are addressed properly, supportive psychotherapy and/or pharmacologic therapy for the depression should be initiated based on the clinical scenario. 

At Hospice of Southern Illinois, we have an expert team of social workers and bereavement counselors. They work hand in hand with our interdisciplinary team to ensure that our patients and their families receive the emotional and psychological support that they need. We also have a full-time pharmacist on staff. Our pharmacist tailors medications to patients’ specific needs.

Hospice of Southern Illinois has been your community, not-for-profit hospice for 40 years. We take great pride in partnering with your medical provider. There comes a time when compassionate care is the best care. Please visit hospice.org or call 800-233-1708 for more information.

Call Hospice of Southern Illinois to learn more about end-of-life care and hospice services, 800-233-1708. Request a chat.

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Hospice of Southern Illinois + Local Schools “Send Love to Seniors”

local students make handmade valentine's day cards for local seniors
send love to seniors in trenton illinois

Does anything warm your heart more than a handmade valentine from a child? There may be a few things, but this idea surely warrants a smile. Hospice of Southern Illinois has coordinated with over 10 local schools to collect handmade Valentine’s Day cards to distribute to long-term care homes and assisted living homes in the Metro East. For 40 years, our goal has been to improve quality of life. Therefore, we took an opportunity to bridge generations together for positivity. The week leading up to Valentine’s Day, hundreds of handmade cards from area schools will land in the hands of seniors. “Send Love to Seniors” is one small gesture Hospice of Southern Illinois is proud to coordinate.

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40 Years of Caring

hospice heroes work here - 40th anniversary graphic

Support, safety, and solicitude lead Hospice of Southern Illinois into the New Year as we continue our service to our patients, their families and our community as we have for the last 40 years. We celebrate 2021 with 40 years of caring. With the challenges of COVID-19 and the rapid evolution of healthcare as we know it, we maintain our reputation for excellent end-of-life care. First, you can expect our caregivers to provide support and education you can trust.  Next, since 1981, we constantly evolve our care model to ensure compassion, dignity and excellence. Finally, we stand by our mission to enhance the quality of life for individuals and their loved ones touched by a terminal illness.

Photo of nursing caring for patient (taken before the 2020 pandemic).

The tradition of living life to the fullest, no matter what time we have left, remains our focus. So, we ask you, as we do every one of our patients, “what is important today?” Find out what that is. Because no matter your age, gender, nationality, race, or diagnosis, quality of life matters.

History of 40 Years of Caring

We started as a grassroots movement in 1981 in Belleville, Illinois. Let’s talk a bit of history before we continue on. After hospice care became widely known from a nurse, Dame Cicely Saunders, in England in 1967, it was recognized in the United States in the late 70’s. Hospice of Southern Illinois was on the forefront in caring for individuals and their families faced with a life-limiting illness. We have heard for 40 years, “I wish I had called hospice sooner.” Hearing these words far too often, we continue to advocate for peace and comfort for all individuals. Don’t delay the unique and individualized care that hospice and palliative care offers to patients and families.

After 40 years of caring, you can count on your local, not-for-profit hospice. Our medical team, caregiver support, and alternative therapies extend our commitment to our end-of-life services and the communities we serve. Further, community engagement and giving back is part of our DNA. It’s a privilege and honor to be available to answer questions when you need us. 

40th Anniversary Message

Take this away from our anniversary message: don’t let the call to Hospice of Southern Illinois wait. The sooner you ask for help, the sooner your loved one receives this special type of care, and the sooner our team of individuals with a hospice heart can focus on the unique needs of your loved one’s end-of-life journey. Everyone deserves a peaceful and comfortable journey. When you think of dignity, ask for us by name. Thank you for trusting 40 years of caring with Hospice of Southern Illinois.

Call Hospice of Southern Illinois to learn more about end-of-life care and hospice services, 800-233-1708. Request a chat.

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Understanding Signs & Symptoms at the End-of-Life

Medical Director Minute with Dr. Ellen Middendorf

Our goal in hospice care is to improve quality of life. At Hospice of Southern of Illinois, we are experts at managing pain and symptoms related to terminal illnesses.  We utilize an interdisciplinary team, including a physician, nurse practitioner, doctor of pharmacy, nurses, social workers, bereavement counselors and hospice aides to provide care to patients and their families. Patients can experience a variety of symptoms at end of life. For example, symptoms may include pain, dyspnea or shortness of breath, constipation, nausea and vomiting, pharyngeal rales or a rattling noise in the back of the throat and terminal restlessness. In short, these are some of the most common. Next, continue reading more information on these specific symptoms.

Common End-of-Life Symptoms & Management

Pain

Pain is a widely prevalent symptom at end of life. It is experienced in up to 70% of patients with advanced cancer, 75% of heart failure patients and up to 93% of patients dying from HIV/AIDS. Pain is also very common in patients with dementia and neurologic diseases, such as multiple sclerosis and cerebrovascular disease. In hospice care, the class of medications called opioids most commonly treats pain.

Dyspnea

Dyspnea is the uncomfortable awareness of breathing, and this symptom can be seen in all disease states. Its presence and severity cannot be inferred from physical exam or laboratory manifestations. It can occur in the absence of physical signs or abnormal findings on labs or radiographs. Therefore, our team must be very astute in listening to their patients and caregivers to ensure that this symptom is treated promptly. We can attempt nonpharmacologic treatment with oxygen and a bedside fan, but, once again, the mainstay of treatment is opioids.

Constipation

Constipation is a troubling symptom that can be caused by a multitude of issues. Problems within the colon, such as cancer or strictures, can be the culprit. Metabolic issues, including chronic diabetes, hypothyroidism, hypercalcemia and chronic kidney disease can contribute. Neurological conditions that include spinal cord injuries, Parkinson’s disease, multiple sclerosis and paraplegia are often associated with constipation. Many medications have constipation as a common side effect, including opiates, some antidepressants, iron supplements, anti-epileptic drugs and anti-Parkinsonian agents. A low fiber diet and an inactive lifestyle often contribute, in addition. Multiple types of laxatives and stool softeners can be helpful.

Nausea and Vomiting

Nausea and vomiting can be particularly distressing and affect an individual’s ability to eat. Additionally, there are a variety of causes. For instance, medications, including chemotherapy, opioids, anti-inflammatories iron, antibiotics, anticonvulsants and antidepressants, are common agents to blame. Electrolyte disturbances, constipation, inflammation or tumors of the gastrointestinal tract, anxiety and bowel obstructions are other common causes. If intracranial pressure increases, either due to tumor or bleeding, this often leads to nausea and vomiting. There are many pharmaceutical agents available to treat nausea. Many are available to use in combination if needed.

“Death Rattle”

Pharyngeal rales is otherwise known as the “death rattle.” This sound is caused by the airways accumulating oral secretions. As a result, the patient loses the ability to clear their airways by coughing and swallowing, and it often occurs within 48 hours of death. Suctioning is ineffective to treat this symptom and may cause discomfort to the patient and a reactive swelling to the airway. The mainstay of treatment is a class of medications known as anticholinergics. Anticholinergics dry secretions.

Terminal Restlessness

The final grouping of symptoms to discuss is terminal restlessness which is common in patients with advanced illness nearing death. The patient may have day-night reversal and is often anxious, restless and has hallucinations. This complex can be difficult to manage and is often irreversible. Therefore, we focus on symptom control and relief of distress for the patient and the family. Pharmacologic agents are used to treat the symptoms that the patient is experiencing.

The Hospice of Southern Illinois Difference

speak with a nurse about end of life symptoms

We will develop a personalized plan of care for all of our patients that meet their individualized needs. Our interdisciplinary team meets weekly to discuss our patients and their end-of-life symptoms to ensure that we are providing the best care possible. To learn more about our care, please visit hospice.org. Additionally, we are very proud to have a PGY2 Pain and Palliative Care Pharmacy Residency. By having a pharmacist on staff, our patients and their families have the benefit of a doctor of pharmacy reviewing and collaborating on every medication profile. To learn more about the medications mentioned above, please visit our app. As a result, you’ll have access to more medication information and other FREE resources.

Call Hospice of Southern Illinois to learn more about end-of-life care and hospice services, 800-233-1708. Request a chat.

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Why the call to hospice shouldn’t wait.

Medical Director Minute

Why the call to hospice shouldn’t wait.

The hospice philosophy of care focuses on quality of life. When a cure is no longer possible, hospice care is designed to treat the whole person and not just the disease. Thus, it behooves an individual and their loved ones to call hospice sooner. The patient and family can take advantage of all the benefits that hospice and its interdisciplinary team can provide. Unfortunately, per the National Hospice and Palliative Care Organization, in 2018, the average length of stay for Medicare patients enrolled in hospice was only 89.6 days with the median length of service being 18 days. Hospice of Southern Illinois can offer comfort and support for any individual with a prognosis of 6 months or less. This report shows the underutilization of this compassionate service.

Call Hospice Sooner For Comfort & Support

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20 Ways Hospice of Southern Illinois Made an Impact in 2020

20 Ways We Made an Impact in 2020

20 ways we made an impact in 2020

Hospice of Southern Illinois had to adapt and evolve this past year due to COVID-19. We are proud to share our annual reflection piece of ways Hospice of Southern Illinois made an impact in 2020. We are a community-based, not-for-profit, free standing hospice. Even with this year’s challenges, we continued engaging communities, fostering trust, and providing excellent end-of-life care when people need us most.

We are here as we always have been. Ask for Hospice of Southern Illinois by name. Here are the 20 ways we made an impact in 2020. We are looking forward to 2021 as we celebrate 40 years of caring. We look to grow and guide as we always have through our mission, to enhance the quality of life for individuals and their loved ones touched by a terminal illness in the forefront.

Proud, Community-Based Hospice

  1. Served over 43,000 families since 1981 – we are your local, not-for-profit hospice with our roots starting right here in the Metro-East and Southern Illinois.
  2. Celebrated our 39th year of serving our communities – Hospice of Southern Illinois is an experienced leader in end-of-life care.
  3. Welcomed Timothy Cruz, PharmD, as our 5th PGY2 (post-graduate, year 2) Pain and Palliative Care Pharmacist – Hospice of Southern Illinois’ Pharmacy Residency Program, in collaboration with the SIUE School of Pharmacy, remains the only accredited PGY2 Pain and Palliative Care Pharmacy Residency Program fully funded by a hospice in the United States. 
  4. Volunteers Handmade Over 4,500 Masks – Due to COVID-19, our volunteers focused on ensuring the safety of patients and healthcare professionals. They donated over 4,500 handmade masks to the community. Additionally, they delivered over 200 greeting, sympathy, and thinking of you cards to our patients and their families.
  5. We Launched a Podcast – “Bringing Life to Hospice” is a new extension of our services. We hope to evoke conversations without fear. It will highlight the importance of planning for a peaceful end-of-life journey and supporting families at the end-of-life sooner.
  6. Welcomed New Associate Medical Director – Dr. Lee, joined Hospice of Southern Illinois’ Associate Medical Director Team to contribute to and help ensure the highest standard of end-of-life care for our patients and families.
  7. COVID-19 Vaccines to Staff – December 2020, the first dose of COVID-19 vaccines were given to ensure protection for our patients, families, and communities!
  8. New Phone App Features – Care | Convenience | Connection: Our newest “Emotional Wellness” video series is a new feature to highlight positivity for the future, in addition to our innovative functions and resources you already rely upon. 
  9. Millie, Our New Pet Therapy Dog, Joins The Team – our pet therapy program is a complimentary service and an extension of our mission. We focus on finding ways to bring comfort and peace to patients and their loved ones. Pet therapy has the power to offer additional support, while adding joy, companionship, social interaction, and emotional connection to individuals at any stage in their end-of-life journey.
  10. Increased Bereavement Efforts – Delivered care and comfort baskets to local healthcare facilities that were affected by COVID-19. Additionally, prayer bears, handmade by volunteers, were delivered to Hospice of Southern Illinois’ patients and families.
  11. Honored Veterans On Veterans Day – Hospice of Southern Illinois, with the help of local youth, delivered 38 veteran gifts and painted residents’ bedroom windows at the Anna Veterans Home. Millie, our pet therapy dog, also provided window visits to raise spirits.
  12. Flag Day – Virtual Folding of the Flag – Hosted our first Facebook Live Ceremony, Folding of the Flag to show our commitment to the We Honor Veterans program during the Pandemic.
  13. Granted A Last Wish – Everyone has something that touches their heart. Recently in 2019, a new St. Louis attraction, St. Louis Aquarium – Downtown at Union Station, grabbed the attention of one of our patients. Hospice of Southern Illinois’ nurse and the social worker asked how we could fulfill a wish for a family. We were able to help organize a trip at no-cost to the family with the collaboration of community partners’ Watermark, Monchino Management, LLC and Hotel Indigo St. Louis.
  14. Collaborated with Community Organizations – New Baden/Trenton COVID-19 Relief, Kassly Mortuary’s 4th Annual Terry Sherfy Christmas Food Drive, Belleville Area Chamber of Commerce’s Winter Accessory Drive for the Homeless, and Southern Illinois Street Rod Association (SISRA). Thank you to these wonderful organizations for your support year after year!
  15. New Patient Care Items – Volunteers created fidget sleeves and palm protectors for individuals in our program with Alzheimer’s and Dementia to increase stimulation and improve receptive or anxious habits. 
  16. Weekly Morale Boosters – During the pandemic, we were looking for ways to engage with residents and connect our community. We found it! Our weekly morale boosters enhanced quality of life in a way we’ve never seen before.
  17. Christmas In July – During the month of July, we brought our own volunteer, Santa, to town for window caroling and delivering Christmas cards, cookies, and gifts to spread holiday cheer.
  18. FREE Virtual CE You Online Program – We moved our regular Continuing Education (CE), Educational Evening Events to a virtual online experience for nurses, social workers and the public.
  19. Dedicated Employees Share Their Passion – Thank you Melise Oakley (1 year), Julie Bartels (11 years), Tasha Deprow (9 years), and John Justis (15 years) for sharing your stories with us! Our core values shape and inspire our organizational culture to stay true to our mission, guide our brand and growth, empower our employees, and achieve our goals. Engaged employees are invested in the success of their co-workers, their team, and the organization, overall. 
  20. Great Place To Work – We are proud to be named a Great Place to Work Certified company! We’re grateful to our team for the excellent service and positive culture they are committed to.
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Stroke & Hospice Care

A stroke is defined as an event in which the blood supply to the brain is either reduced, or eliminated. There are multiple types of stroke including ischemic (a blocked blood vessel) and hemorrhagic (a brain bleed). Ischemic strokes are more common than hemorrhagic strokes. According to the CDC, somebody in the United States has a stroke every 40 seconds and somebody dies of a stroke every 4 minutes. After a stroke, patients may have weakness, pain, numbness, urinary and bowel incontinence, swallowing issues, and memory issues, in addition to many other symptoms.

Pain Management

Hospice care can be very beneficial in patients after a stroke as one of the specialties of hospice in the management of pain and other symptoms. One interesting aspect of post stroke symptoms is called central post stroke pain (CPSP). This is a neurologic, or nerve induced, pain that typically affects the body in the areas in which the stroke had its effect. If the strokes lead to left sided weakness, the CPSP would most likely occur on the left side of the body. Most commonly, we can attempt to treat the pain with antidepressant and anticonvulsant medications that are known to be effective for nerve pain. Opioids, while usually effective for pain, are not the most effective for CPSP. Additionally, the same antidepressants can also help to curb other symptoms, such as post stroke vomiting.

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End-State Liver Disease

                Liver failure, or end state liver disease (ESLD) is a devastating illness that, unfortunately, can only be cured by a liver transplant. End state liver disease (ESLD) develops for a variety of reasons including alcohol use, hepatitis C, and obesity.  Patients with liver cirrhosis do not usually experience symptoms until later in the disease progression when the blood pressure in the liver increases. Complications of liver disease include ascites (liquid in the abdomen), vein dilation in the esophagus, altered mental status, infections, and gastrointestinal bleeding. The liver is a very important organ in regulating medications within the body and their excretion.

Hospice of Southern Illinois Admission Team Hospice of Southern Illinois' Admission Team Belleville

                As with most end-of-life conditions, focusing on symptom management becomes important for keeping the patient comfortable. Pain, is a very common symptom that we can see in hospice patients with ESLD. Unfortunately, because of metabolism changes that come with ESLD, some of our traditional options for pain, such as morphine and acetaminophen, should be avoided or, at the very least, used cautiously. The reason for this is because when the medication cannot be cleared from the body it can build-up and become toxic, leading to overdose.

End State Liver Disease & Hospice Care

                The most common complication seen with ESLD is ascites. Ascites is a very unpleasant experience in which the abdomen swells due to fluid build-up.  Ascites can lead to feeling nausea, tired, short of breath, and general discomfort. The treatment of choice for ascites is diuretic therapy with multiple different water pills to drain the fluid. In some cases, if severe, the fluid can be drained through a procedure called a paracentesis. Hospice and palliative care has a huge role to play, using both medication and non-medication strategies, in keeping ESLD patients comfortable.

Call Hospice of Southern Illinois to learn more about end-of-life care and hospice services, 800-233-1708. Request a chat.

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Keep Learning On Our Podcast

Bringing Life To Hospice Podcast

Together, hospices around the country are finding ways to make sure families stay safe and supported! We are launching a podcast in honor of National Hospice Month. It is an exciting extension of Hospice of Southern Illinois’ services. It is called Bringing Life to Hospice. We hope to evoke conversations without fear. It will highlight the importance of planning for a peaceful end-of-life journey. With comfort, education, and safety top of mind, Hospice of Southern Illinois is always looking for ways to support you. More information about hospice, palliative care, and advance care planning is available now. Visit our website, www.hospice.org, or from the National Hospice and Palliative Care Organization’s website, CaringInfo.org.

 

Apple Podcasts:

Episode 1: Bringing Life to Hospice

Serving Those Who Served: Providing Serious Illness Care to Veterans


Hospice of Southern Illinois delivers Veteran-centric care to the Community as a Level 4 We Honor Veterans partner

As the nation honors these American heroes for their military service on Veterans Day, November 11, Hospice of Southern Illinois extends recognition and Veteran-centric care to military Veterans and their families when facing a life-limiting illness throughout the year. This year we will honor Veterans in our program by offering a handmade gift by our volunteers and a certificate through the We Honor Veterans program. It’s a privilege to care for and provide a token of appreciation to Veterans who have gone above and beyond for us.

As a We Honor Veterans partner, Hospice of Southern Illinois is providing specialized care to Veterans who are facing a life-limiting illness and their families throughout the year. This includes a Veteran-to-Veteran volunteer program, recognition and pinning ceremonies, and assistance navigating veteran benefits.

[Read more…]

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