Hospice of Southern Illinois

Premiere Local Hospice Provider

Cardiovascular Medications in Hospice Patients

Matthew D. Clark, Pharm.D.

Dr. Matthew Clark PGY2 Pharmacy Resident for Our 4th Year of Our Pharmacy Residency Program
PGY2 Pharmacy Resident

The leading cause of death in the United States is cardiovascular disease. With the rise in the number of tobacco users along with our society’s push for fast food, this statistic should come as no surprise. Cardiovascular diseases can range from heart attack and stroke to congestive heart failure. What commonly accompanies these diseases is hypertension, or high blood pressure. Your body produces a substance called renin which leads to vasoconstriction that ultimately leads to high blood pressure. High blood pressure can also lead to kidney damage. In addition to hypertension, people with cardiovascular issues tend to have high levels of cholesterol. Astonishingly, our bodies contain both good and bad cholesterol. Low-density lipoproteins (bad cholesterol) hang out in our vascular system while our high-density lipoproteins (good cholesterol) work to transport our bad cholesterol to the liver to be metabolized. Build-up of bad cholesterol leads to plaque formation which ultimately leads to stroke. Fatty foods such as hamburgers and pizza can increase levels in bad cholesterol.

Elevated blood pressure and cholesterol ultimately lead to adverse cardiovascular events that can often lead to death. In order to avoid these events, patients are prescribed agents that lower blood pressure and cholesterol. It is common for patients to be on these classes of medications for numerous years. What about patients in hospice who are approaching the end of life? Is it appropriate for these patients to continue strict control on their blood pressure and cholesterol? Indeed, cardiovascular risks are very serious; however, these events are usually the long term effects of uncontrolled blood pressure and cholesterol. Therefore, the need for these medications at the end of life becomes moot. These medications can actually adversely affect the dying patient. For example, tightly controlling a patient’s blood pressure with medications can sharply drop their blood pressure which leads to falls and injury. Additionally, a certain group of cholesterol medications known as “statins” can lead to muscle breakdown and wasting in patients who are bed bound. As a result, these medications are commonly discontinued in hospice patients.

A goal for healthcare providers in hospice is to provide optimal comfort to the patient during the final moments of their life. One way to accomplish this is to minimize the amount of unnecessary medications the patient is taking. As frightening as stopping blood pressure and cholesterol medications may be, patients and families must realize that healthcare professionals, such as pharmacists, weigh the risks versus benefits of discontinuing medications. In this case, the risks of adverse events caused by continuing these medications outweigh the benefits of cardiovascular protection these medications provide for hospice patients. Cardiovascular medications are just one of many medication classes that can benefit hospice patients by being discontinued.

19 Ways We Made An Impact in 2019

19 Ways Hospice of Southern Illinois Made an Impact in 2019

Hospice of Southern Illinois is a community-based, not-for-profit, free standing hospice. We give back, connect with people, and build relationships to foster trust and offer excellent end-of-life care when people need us most. We are proud to share 19 ways we made an impact in 2019. We challenge ourselves and our employees, year after year, to stay engaged and continue the tradition of a caring and giving heart! We are looking forward to 2020. While we look to grow and serve more people, always in the forefront is our mission: to enhance the quality of life for individuals and their loved ones touched by a terminal illness.

  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 38th year of serving our communities – Hospice of Southern Illinois is an experienced leader in end-of-life care.
  3. Welcomed Matthew Clark, PharmD, as our 4th 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. Moved to our new clinical office – located at 333 South Illinois Street, Belleville, IL. The new Belleville Patient Services Location will bring our patient services and administrative teams closer together. Further, the space offers warmth and professionalism. While paving the way for our future growth, it pays tribute to our steadfast, rich history. Altogether, we are proud to showcase it to the residents of the  Metro-East.
  5. Reached 5,000 Likes on Facebook – we are your resource for hospice education and news locally. Thank you for your support, stories, likes, comments, shared dedication, compassion and trust for our mission and those we serve!
  6. Marion Honor Flight – Hospice of Southern Illinois’ volunteers served on the Welcome Home Committee for the Veterans Honor Flight Volunteer Group. This group welcomed home 6 flights, actually attending 1 of the 6 Honor Flights. Moreover, 480 Veterans attended these 6 flights. Additionally, about 2,500 community members welcome each flight home at the Veterans Airport of Southern Illinois.
  7. Hosted 15 Virtual Flight of Honor programs – together with community members from Alton, Belleville, Columbia, Millstadt, New Athens, Red Bud, Sparta, Swansea and Waterloo, Hospice of Southern Illinois honored over 200 Veterans. Without a doubt, Veterans and community members alike feel the honor, pride and appreciation when experiencing the typical “honor flight day” without leaving their hometown. 
  8. Expanded Pet Therapy Program – 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. 
  9. Volunteers donated over 9,000 hours – individuals came together and shared their time and talents with patients, families and employees to support our mission. As a result, volunteers gave back over $244,000 in exchange for their time!
  10. 7% of volunteer hours were in direct patient care – Medicare requires a minimum of 5% of volunteer hours in patient care. Our dedicated volunteer teams exceeded this requirement. (Photograph: The Fidget Blankets project comes from Hospice of Southern Illinois’ Volunteer Barb Kunstman. She has been sewing our logo on all of the Butterfly Pillows, clothing covers, medical supply covers, and lap quilts for years. Most importantly, these are given to our patients year after year.)
  11. Presented and hosted over 130 presentations – we offer presentations, education, and resources at minimal or no cost to healthcare professionals, organizations and community groups.
  12. Collaborated with community organizations – Carlyle Lions Club, Greater Belleville Chamber of Commerce’s Healthcare Committee Coat Drive, First Southern Bank + Employees, Highland Area Community Foundation, Kassly Mortuary 3rd Annual Christmas Food Drive, and Southern Illinois Street Rod Association (SISRA). Thank you to these wonderful organizations for your support year after year!
  13. Music and Memory – In 2019, Hospice of Southern Illinois began the MUSIC & MEMORY® Certification Program. As a result, certification ensures families and their loved ones have access to the therapeutic benefits of music. Additionally, it shows our commitment to person-centered care.
  14. Hospice Month Campaign To Enhance Quality of Life – we launched a National Hospice Month campaign, “Living with Hospice.” As an example, we showcased the moments and memories that matter most between families, friends, and caregivers who are touched by a life-limiting illness throughout their final months and weeks. Those featured in the photographs live each day to the fullest, making all of their days count.
  15. Involved in Salute to Scott – this O’Fallon-Shiloh Chamber celebration welcomes Scott Air Force Base residents, veterans and community members in finding fellowship through a community event. Hospice of Southern Illinois has been volunteering for over 10 years at this celebratory event!
  16. Employees Celebrate Milestone Anniversaries – we are honored and proud to have employees who have a hospice heart and are the very reason we can continue our mission and philosophy. Specifically, they have been growing, changing and caring with us for over 20 years! Thank you, Deborah Hunter, 27 years, Donna Hinant, 23 years, Angela Stoeckel, 22 years, Jane Gazda, 21 years, Deborah Hogg, 21 years, and Pamela Rorie, 20 years. Thank you all your dedication to our organization and those we serve.
  17. Welcomed New Associate Medical Director – Dr. Joseph Jackson, effective June 1, 2019, 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.
  18. Updated our free phone app – Care | Convenience | Connection, Innovative functions, solutions, and resources to answer your questions and foster engagement at your fingertips. 
  19. Skills Lab – our education department has developed a one-of-a-kind skills lab to ensure our nurses have consistent, safe training. Additionally, collaborations with local colleges and universities allow our student interns the access to this distinctive, educational resource.

National Hospice Month: Raising Awareness of the Benefits of Hospice Care

Hospice of Southern Illinois Celebrates November as National Hospice Month

“Hospice of Southern Illinois is about meeting people where they are. Meeting people where they are isn’t about a physical location. It’s about an emotional connection.”
Hospice of Southern Illinois has been providing compassionate care to terminally ill patients and their families in their home or a home-like setting since 1981.

Throughout the month of November, Hospice of Southern Illinois will be joining organizations across the nation hosting community activities in recognition of National Hospice and Palliative Care Month. 

For more than 40 years, hospice has helped provide comfort and dignity to millions of people, allowing them to spend their final months at home, surrounded by their loved ones. Hospices ensure that pain management, therapies, and treatments all support a plan of care that is centered on the patient’s goals. This care also provides emotional support and advice to help family members become confident caregivers and adjust to the future with grief support for up to a year.

“Living with Hospice”
We want to showcase the moments and memories that matter most between families, friends, and caregivers who are touched by a life-limiting illness throughout their final months and weeks.

The Hospice Philosophy

“It is essential that people understand that hospice and palliative care is not giving up, it is not the abandonment of care, and it is not reserved for the imminently dying,” said Edo Banach, president and CEO of the National Hospice and Palliative Care Organization. “Hospice is a successful model of person-centered care that brings hope, dignity and compassion when they are most needed. This is one reason that the national My Hospice Campaign was launched in 2018.”

[Read more…]

Benign Prostatic Hyperplasia

Tamsulosin and Fall Risks 

Pharmacist listening to patient explaining his symptoms for Benign Prostatic Hyperplasia (BPH)
Many male patients in hospice have a diagnosis of BPH and, therefore, the benefit of symptom management must outweigh the risks of fall and injury before tamsulosin is continued in a patient.

Benign prostatic hyperplasia (BPH) is one of the most commonly diagnosed diseases in men. Benign prostatic hyperplasia (BPH) tends to develop in men over the age of 40 and affects up to 60% of men over the age of 90. Over time, the prostate tends to become enlarged mostly due to the increased level of androgens in aging males. This can be caused by comorbidities such as metabolic syndromes, obesity, alcohol consumption, and lack of exercise. Men who experience BPH can have increased urinary frequency, increased urinary urgency, incomplete voiding, and dribbling. Likewise, symptoms of BPH can bring levels of discomfort, especially in the elderly. Tamsulosin is the preferred treatment of BPH and exerts its mechanism by binding to alpha-1a receptors in the prostate, bladder neck, and prostatic urethra. By binding to these receptors, tamsulosin allows smooth muscle relaxation ultimately leading to the decrease in BPH symptoms. 

[Read more…]

Is Insulin Appropriate for Hospice Patients?

Understanding Diabetes and Insulin

Worldwide, type II diabetes mellitus accounts for almost 10% of the population and was associated with almost 2 million deaths in 2016. Typically, diabetes affects those with a family history but can also arise idiopathically (without known cause). What this means for patients is frequent doctor’s appointments, diet modifications, and diabetic medications (potentially insulin). Normally, our pancreas secretes insulin whenever we eat in order to shift glucose from our blood to our cells. In patients with type II diabetes, the insulin in which the pancreas secretes fails to transfer glucose into the cells. As a result, blood glucose elevates. Lowering a diabetes patient’s blood glucose requires extra insulin to move glucose into the cells. Therefore, insulin is a common therapy for patients with diabetes. Diabetes management is crucial to prevent complications caused by the disease such as painful neuropathies, ocular toxicities, and renal toxicity.

Hospice patient getting a blood glucose reading from a nurse

“A big challenge when deprescribing a hospice patient’s medications is convincing the patient to discontinue insulin, especially, if they have been taking it for numerous years. A common fear is that their blood glucose will rise uncontrollably.”

Continue Reading, Click Here: Insulin for Hospice Patients

Ribbon Cutting & Open House

We are excited to celebrate a milestone, the move to our New Belleville Clinical Office location, 333 South Illinois Street, Belleville, in July. To commemorate the move, Hospice of Southern Illinois is hosting a Ribbon Cutting & Open House. Join us on Wednesday, November 6, 2019, from 4:00 p.m. – 6:00 p.m. Enjoy a Ribbon Cutting at 4:00 p.m. followed by an Open House with light refreshments and office tours until 6:00 p.m. This event is open to the public, chamber members, and Hospice of Southern Illinois’ current employees, volunteers, and retirees. 

New Belleville Clinical Office Location

Ribbon Cutting and Open House Invitation for November 6, 2019, from 4-6 p.m.

The new Belleville Clinical Office location will bring our patient services and administrative teams closer together. The space offers 8,000 square feet of warmth, professionalism, and class. You’ll see a featured acrylic logo wall decal on a burgundy wall to highlight our brand and rich history when you enter the newly renovated building. With more collaborative spaces, family consultation and support areas, advanced technology, and modern team offices, we are proud to showcase our new Belleville Clinical Office Location to the residents of the Metro-East. 

Why the move?

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The Good Death

Over the past century, the viewpoints of death have had a definite shift within society. This can be attributed to the shift in medical care from family settings to a more institutionalized setting. As a result, what used to be considered a natural part of life is now viewed as a failure in medical technology. Today, we tend to think as a society that the ideal death would be in our sleep without suffering. In contrast, the medieval era believed that death should be by noble cause, and it’s said that people of that time actually prayed to not die in their sleep. Understandably, the various viewpoints of “the good death” can make providing comfort for hospice patients a challenge.

bird flying away peacefully into the light representing a peaceful end of life journey

In addition to the various cultural differences in the perception of a good death, there also tends to be a difference among healthcare professionals, families, and patients.

Continue Reading, Click Here: Other Influences & Considerations

End of Life Care Agents for Parkinson’s

By: Matthew Clark, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care, Hospice of Southern Illinois   October is American Pharmacists Month and we present to you a series of end-of-life topics throughout the month by our very own, Matthew Clark, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care! Our series will help expand your understanding of the field and debunk some myths in the field of pharmacy. Topic 2 : Best Agents for Psychosis Related to Parkinson’s 
Arthritis hand and knee pain or mental health care concept with geriatric doctor consulting examining elderly senior aged adult in medical exam clinic or hospital
Parkinsonism is a disease that is prevalent across the elderly population. In fact, Parkinson’s affects 1% of patients above the age of 60 in the United States. The disease is due to an insufficiency of dopamine and dopamine receptors in the area of the brain called substantia nigra. The loss of dopamine leads to common symptoms associated with Parkinson’s disease such as: bradykinesia, shaking, tremors, and rigidity. In addition to Parkinsonism, patients can develop psychosis during the late stages of the disease. As healthcare professionals, it is important to choose the most appropriate agent to treat psychosis without exacerbating Parkinson’s symptoms. [Read more…]

What’s the difference between Palliative Care and Hospice?

By: Matthew Clark, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care, Hospice of Southern Illinois

October is American Pharmacists Month and we present to you a series of end-of-life topics throughout the month. Our author is our very own, Matthew Clark, PharmD, PGY-2 Pharmacy Resident in Pain and Palliative Care! Our series will help expand your understanding of the field and debunk some myths in the field of pharmacy.

The goal of hospice care is to achieve the best quality of life for patients and families with a prognosis of 6 months or less.

A common misconception in healthcare that can cause great distress and confusion to patients is that palliative care means hospice. The two terms are often inadvertently used interchangeably. Despite both areas being oriented around symptom management, it is important to understand the differences. The World Health Organization (WHO) defines palliative care as the active total care of patients whose disease is not responsive to curative treatment. This approach aims to improve the quality of life of patients and their families through prevention of suffering by assessing and treating their symptoms.

Similarly, the goal of hospice care is to achieve the best quality of life for patients and their families. However, hospice is a service covered by Medicare Part A, Medicaid, or private health insurance. Patients who qualify for hospice have a terminal illness with a prognosis of 6 months or less. Terminal illnesses may include malignancies such as cancer, congestive heart failure, and chronic obstructive pulmonary disease (COPD). A hospice team consists of a physician, registered nurse, social worker, hospice aide, pastoral counselor, volunteers, and pharmacist.

Understanding The Difference

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Announcing Pharmacy Residency Program’s 4th Year

Dr. Matthew Clark PGY2 Pharmacy Resident for Our 4th Year of Our Pharmacy Residency Program
PGY2 Pharmacy Resident

Hospice of Southern Illinois is announcing our 4th year with a PGY-2 (post-graduate, year 2) Pain and Palliative Care Pharmacy Residency Program. In collaboration with the SIUE School of Pharmacy, we remain the only accredited PGY-2 Pain and Palliative Care Pharmacy Residency Program fully funded by a hospice, in the United States. With that said, we are pleased to introduce and welcome the full-time, on-staff, PGY-2 Pharmacy Resident, Matthew Clark, PharmD. Our patients, families, and organization directly benefits from this very special program, which is 1 of 18 in the country and the only accredited one, fully funded by a hospice.

Dr. Clark is an integral member of our interdisciplinary team focusing on each individual’s goals of care in delivering the highest quality end-of-life care to the patients and families we serve. Matthew leads with our mission and core values of excellence, integrity, respect, diversity and dignity. The PGY-2 Program sets Hospice of Southern Illinois’ care apart from other hospice programs. Matthew shares our commitment to this program and standard of end-of-life care, “I am truly blessed to have the opportunity to learn from such a caring healthcare team at Hospice of Southern Illinois. Completing the residency at Hospice of Southern Illinois will allow me to grow as a competent palliative care pharmacist.”

[Read more…]

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