Christy Kessler, Author at Hospice Basics

Oct 09

Two mature women sitting together outside, one comforting the other

Anticipatory Grief and How to Cope

By Christy Kessler For Caregivers & Families, Grief & Loss

Have you heard of anticipatory grief? If you have a terminally ill loved one, you may already be experiencing its effects. To help you better understand what you’re feeling and how to cope with it, let’s talk about anticipatory grief and several tips for coping with it as you make the most of your remaining time together.

What is Anticipatory Grief?

Anticipatory grief, also known as preparatory grief, is a type of grief that occurs before the actual loss or death of a loved one. This form of grief is a common experience among family members and friends of a terminally ill person. Anticipatory grief can be complex and challenging, as individuals may experience various emotions, including stress, sadness, anger, guilt, and anxiety.

Anticipatory grief can be a positive or a negative experience. On the one hand, having time to process the emotions of grief before the loss can spur you to make meaningful choices. For example, you could spend more time with your loved one, or take the opportunity to have meaningful conversations and say things you’ve always wanted to.

On the other hand, the stress of watching someone you love slip away a little at a time, such as with Alzheimer’s disease or cancer, can bring about feelings of helplessness, anxiety, and stress.

5 Strategies for Coping with Anticipatory Grief

If you are dealing with anticipatory grief, these five coping strategies can help you process your complex emotions and gain peace even in a difficult situation.

1. Practice Mindfulness

Anticipatory grief can be overwhelming and all-consuming. Practicing mindfulness can help you stay present and grounded. Take a few moments each day to focus on your breath and observe your thoughts and feelings without judgment.

You may reflect on the things you are grateful for learning from the person you love. What valuable lessons have they taught you? What values have they passed on that you will carry with you after they are gone? Feel free to share these thoughts with the person you love, if you can. It will mean more to them than you know!

2. Connect with Others

Anticipatory grief can feel isolating because the loss has not yet occurred. That is why reaching out to friends, family members, and mental health professionals who understand what you’re going through is so important. Understanding and acknowledging anticipatory grief can help you cope with the impending loss and find meaning and peace during a difficult time. Join a support group or seek out a therapist who can provide guidance and support throughout this journey and beyond.

3. Take Care of Yourself

Grief of any kind can be physically and emotionally exhausting. Take care of yourself by getting enough sleep, eating well, and engaging in activities that bring you joy.

If you are a primary caregiver for a terminally ill loved one, practicing self-care is crucial to your well-being. Feelings of frustration and burnout can make anticipatory grief even more challenging because you might feel guilty for getting angry or losing patience.

Ensure that you are not neglecting your needs as you care for another individual. You might take a walk to clear your mind, take a nap if you are exhausted, and follow routines that keep you grounded and centered.

4. Express Your Feelings

It’s essential to allow yourself to feel your emotions and express them in healthy ways. Write in a journal, create art, or talk to a trusted friend about your thoughts and feelings.

Emotions can hold power over us if they go unacknowledged and unexpressed. But when you name an emotion, it loses some of its power. Even if your emotions are not what you want them to be, take the time to understand them and find a way to express them.

5. Focus on What You Can Control

Anticipatory grief can feel overwhelming because it involves so many unknowns. Focusing on what you can control rather than what you can’t control is helpful.

Preparing for a loss in practical ways may help bring a sense of control. You may want to focus on estate planning, funeral planning, and even writing the obituary in advance.

Gather a team of experts around you to help you. Your team might include an estate planning attorney, a funeral planning specialist from the funeral home, hospice nurses, caregivers, and an accountant who can assist with tax issues and questions.

The more prepared you are for a loss, the more you will be able to be in the moment with your loved one in their last days and weeks.

Woman sitting quietly at home with a cup of tea, looking out window and thinking

Anticipatory grief can be a challenging and emotional experience. However, these five strategies can help you cope and navigate this difficult time with grace and strength. Remember that grief is a natural part of the human experience, and it’s okay to seek help and support when you need it. With time and patience, you will find a way to honor the memory of your loved one and move forward with peace and healing.

Aug 03

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Assortment of medical supplies, like gauze, bandages, and scissors

Does Hospice Care Include Medical Supplies & Equipment?

By Christy Kessler For Caregivers & Families, Hospice

For most families, hospice care takes place right inside the home. But your home isn’t a medical facility – how do you access the medical equipment and supplies needed to properly care for your terminally ill loved one?

Thankfully, Medicaid, Medicare, and most private insurance companies provide generous coverage for hospice care, including medical equipment and supplies. In most cases, the family won’t have to pay for any medical equipment or supplies out of pocket, but always confirm with your insurance provider so you don’t end up with unexpected expenses. Some insurance companies require that you acquire equipment from certain sellers.

Now, to give you a well-rounded understanding of hospice medical equipment and supplies, let’s review 6 frequently asked questions.

How do I know which medical equipment or supplies my loved one needs?

Short answer: Talk to your terminally ill family member’s doctor. When you first request hospice care, both the primary care physician and the hospice medical director will assess your loved one’s overall health. If they certify that your loved one is eligible for hospice care, they will also determine what medical equipment and supplies are needed for your family member’s care.

Then, your hospice team of experts will work closely with you to coordinate the delivery and set-up of any equipment at your home. As your loved one’s condition changes, the equipment and supplies will change. For example, an oxygen tank may not be needed in the first month of hospice care, but it becomes necessary in the third month. Your loved one’s care is a continually evolving process, and your hospice team will help you navigate those changes.

What items qualify as “medical equipment”?

Medical equipment refers to items that are re-usable or intended for long-term use. Every hospice patient’s situation and care regimen are different, but some items commonly considered “medical equipment” are:

Hospital bed
Oxygen equipment
Geriatric recliner
Bedside commode or bedpan
Nebulizer
Shower chair
Wheelchair
CPAP machine
Blood pressure monitor
Walker or crutches
Bed lift
Feeding pump

This is not a comprehensive list, but it gives you a sense of which items are considered medical equipment. Your hospice team will continually assess your loved one’s condition and ensure that the right equipment is delivered when it becomes necessary.

What items qualify as “medical supplies”?

On the other hand, medical supplies are designed for one-time use. They are often easier to acquire and will be replaced as needed. Here’s an example list of medical supplies:

Bandages and gauze
Briefs, pads, and other continence care supplies
Disposable gloves, needles, or syringes
Oxygen tubing
Personal care products, like soap and shampoo
Cushions and wedges
Catheters

You can certainly purchase any personal care items on your own, but hospice care will provide them, if you wish.

Will someone show me how to use the medical equipment and supplies?

Absolutely. A member of your hospice team will clearly explain how to use each piece of medical equipment. They will also educate you on the correct use of any medical supplies, as you may need to clean wounds or administer medications. If you have questions, your hospice provider will provide an emergency assistance number.

What happens when the medical equipment is no longer needed?

As your loved one’s condition evolves, medical equipment will come and go in your home. When something is no longer needed, your hospice team will arrange its removal.

Are there any extra supplies I should gather?

When you sign up for hospice care, the admissions nurse may suggest that you purchase a few supplies. While most things are provided through your insurance policy, there may be some items to purchase on your own. Confirm with your chosen hospice provider, but here are a few items you might choose to have on hand.

Twin sheets (two sets)
Disposable or cloth under-pads
Baby monitor or bell for the patient to use when they need help
Thermometer (forehead type is best)
Bendable straws (if the patient does not have swallowing issues)
Mild or bland food (like oatmeal, applesauce, pudding, or yogurt)
Night lights for hallways and rooms
Wastebasket near the bed
Loose nightshirt or nightgown

You are not required to have any of these items on hand, but it may make the transition to hospice less stressful if you are prepared in advance. You can always double-check with the hospice provider to see if they will provide these items. In some cases, they will.

If you have more questions, reach out to a respected hospice provider in your area. They can answer any additional concerns you may have, regarding medical equipment or hospice care in general.

Feb 22

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illustrates how patient can benefit from respite care

What is Hospice Respite Care?

By Christy Kessler For Caregivers & Families, Hospice No Comments

Caring for a terminally ill loved one is often equal parts rewarding and exhausting – physically, mentally, and emotionally. There are some amazing days where you make meaningful memories that will last a lifetime. Other days challenge you to the end of your endurance. To help caregivers stay balanced and prevent caregiver burnout, respite care is available to help.

What is Respite Care?

Respite care is short-term, in-patient care, designed to give family caregivers an occasional break to re-charge and rejuvenate. In many cases, Medicare benefits pay for patient transport and up to five (5) consecutive days of in-patient care at a Medicare-approved nursing home, hospital, or hospice facility. You can use respite care more than once, but only once during each benefit period. In case the term “benefit period” is unfamiliar, it refers to a 90-day period of care that your loved one can receive before they must re-certify that they are still eligible for hospice care.

Also, while many insurances (including Medicare) help cover this type of care, there may be a minimal cost to the family. Check with your insurance provider before entering into respite care.

Why Would I Request Respite Care?

Being a primary caregiver is an admirable undertaking. Caregiving takes strength, patience, and perseverance. It is not an easy task, and the demands on your time can pile up quickly.

With the challenges of caregiving, you might request respite care for many reasons, including:

Taking a Break

Caring for a dying loved one requires a lot of time, energy, and commitment. Over time, you may begin to experience “caregiver burnout” – physical and emotional exhaustion. With respite care, you can take a few days off to re-charge and care for yourself. This break provides an opportunity to rest and relax without worrying about the level of care your terminally ill loved one is receiving.

Focusing on Personal Health

Caregivers often neglect their own needs and are continuously giving their time, energy, and effort to caring for their dying loved one. Unfortunately, it’s not uncommon for family caregivers to experience depression, insomnia, changes in appetite, or become more susceptible to illness. Respite care gives you an opportunity to focus on your own health and wellness, so that you can come back with renewed energy.

Recovering from an Illness

Though this reason is similar to focusing on personal health, it’s more focused on sickness. If you catch a cold, the flu, or some other transmittable sickness, you definitely don’t want to pass that illness on to your terminally ill loved one. With respite care, you can take a few days to recover from your own sickness before returning to care for a loved one.

Attending Important Events

Life keeps moving forward, even when someone you love is dying. That means, there may still be weddings, graduations, or other events that you must attend. With respite care, caregivers can take a few days to attend these events without worrying about medical care.

Getting Increased Care for Your Loved One

Throughout the hospice journey, your loved one will experience ups and downs with their health. There will be times when their pain and symptom management is too much for you to handle on your own at home. During these times, you can request in-patient care where your loved one can receive the medical care they need for more severe symptoms.

Now that we’ve discussed a few reasons why you might request respite care, let’s talk about the benefits.

How Does the Caregiver Benefit from Respite Care?

For those who still aren’t sure about taking time away from a loved one, here are some of the biggest benefits caregivers see when they take advantage of respite care.

Improved sleep
Increased energy
Improved outlook
Reduced levels of stress and anxiety

Requesting respite care may feel like claiming a weakness or demonstrating that you don’t have what it takes to care for a loved one, but that couldn’t be further from the truth. The reality is – what you’re doing is hard and exhausting. Knowing your limits and taking time to care for yourself is a good thing. It will give you the energy you need to provide better quality care for your loved one and be at your best when they need you most.

How Does the Patient Benefit from Respite Care?

While respite care may seem like it mostly benefits the caregiver, there are also many benefits to the patient, including:

Reduced guilt over their caregiver’s stress or anxiety; glad to give their caregiver a break
Increased social interaction opportunities
Improved relationship to caregiver; stress affects both the caregiver and the patient

It’s beautiful and good to receive care at home from a loved one, but at times, everyone needs a break. With respite care, both caregiver and patient can come back together more refreshed.

How Often Can I Request Respite Care?

With hospice care, there are benefit periods, and you can request respite care once per benefit period. Under special circumstances, you might be able to receive additional care, but you will likely need supporting documentation to ensure the request is valid.

Every caregiver’s life comes with its challenges. If you just can’t provide the at-home care necessary for a dying loved one, consider looking into another living situation. Perhaps a different family member can step in to assist or you can look into care at a hospice facility or nursing home. To learn more about the options, go to “Where Can You Receive Hospice Care?”

But remember – to the hospice team, your loved one’s wishes always come first and supersede anything else. Be sure to discuss the options with your loved one before talking to the hospice team about any changes in location of care.

How Do I Request Respite Care?

If you’d like to request respite care, the best thing to do is talk to your hospice care team. They will help you prearrange dates for care and ensure that all the details are taken care of. If you aren’t sure when it would be a good time to be away, the hospice team can assess your loved one’s medical situation and give you guidance on timing.

Now that you understand the value of respite care – to both the caregiver and the patient – don’t be afraid to use this beneficial service for your well-being.

Jan 18

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How to Prepare for a Funeral Preplanning Appointment

By Christy Kessler Estate Planning, Meaningful Funerals

If you’ve recently received a terminal diagnosis, now is the time to make your final wishes known (if you haven’t already). With everything else going on, preplanning may feel daunting, but that’s where a preplanning specialist can help. They specialize in sitting down with you (and your family, if you’d like) to listen to your wishes, review all the options, answer your questions, and help you put your preferences in writing.

If you’d like to learn more about planning ahead, check out “What is Advance Funeral Planning?” for a deeper look at why planning ahead can benefit both you and your family.

What to Expect at a Preplanning Appointment

During your chat, the preplanning specialist will listen to your thoughts and answer your questions. They will help you understand your options, so you can make plans that balance your own personal wishes with the emotional needs of your family. A few general topics will likely come up. Let’s review them.

1. Vital Statistics

The preplanning specialist will ask for some specific vital statistics. After death, there are many documents that must be submitted to state and local authorities, and they each require certain information. With the vital information provided, the funeral director can obtain the necessary permits for burial or cremation, help prepare the obituary, and submit a request for a death certificate. And for veterans, the funeral director can use vital statistics to request military honors, if you wish.

When possible, consider bringing these vital statistics to your preplanning appointment:

Full legal name
Address
Race and gender
Date of birth
Social Security Number
Occupation (kind of business or industry)
Marital status
Spouse’s name (if applicable)
Maiden name (if applicable)
Father’s name
Mother’s maiden name
Education information
Armed Forces information (including DD-214)
Names of surviving spouse and family members

2. Funeral Preferences

As you might expect, your funeral preferences are going to be a topic of conversation during a preplanning appointment. Here are a few things you may discuss with the preplanning specialist as you determine what’s right for you and your family.

What type of final disposition do you want? (burial, cremation, anatomical donation, etc.)
What kind of service do you want?
Where do you want the service to take place?
If you prefer burial, have you already purchased a cemetery plot? If so, where?
Who would you like to take part in the service? For example, eulogists, pallbearers, etc.
Would you like a gathering for mourners after the service?

There will be more questions, of course, but these give you an idea of what to expect during your preplanning discussion. If you’d like a more in-depth guide, click on our Funeral Planning Checklist and start filling it out today. You can take the completed checklist to your preplanning appointment and discuss your selections with the preplanning specialist.

3. Personalization Preferences

Just as no two people are the same, no two funeral services should be the same. That’s where personalization preferences come in.

Dr. Alan Wolfelt, a nationally respected grief counselor and educator who has walked alongside thousands of people on the grief journey, tells us:

“Focus on what is really important—what is essential—about the funeral you are planning. What is essential is the life that was lived and the impact that life had on family and friends. To honor that unique life, the funeral must also be unique. Over and over families tell me that the best funerals are those that are personalized.”

Personalization is the key to creating a healing and meaningful experience that will meet the emotional needs of family and offer comfort throughout the grief journey. During your appointment, you can brainstorm personalization ideas with the preplanning specialist. They will offer ideas based on their own personal experience in the funeral profession.

To help you get a sense of what funeral personalization means, here are a few resources:

Why Does Funeral Personalization Matter?

7 Elements of a Healing and Meaningful Funeral

Practical Ways to Personalize the 7 Elements of a Funeral

The Core Elements of a Military Honors Funeral

4. Veterans’ Burial Benefits

For honorably discharged veterans, the preplanning specialist will discuss the burial benefits that are available. Dependents and survivors of veterans may also be eligible for VA benefits.

The main burial benefits available to veterans include (at no cost to your family; all benefits apply both burial and cremation):

Burial allowance
Interment at a national cemetery
Headstone or grave marker
Burial flag
Presidential Memorial Certificate
Military honors

If you aren’t familiar with what each of these benefits entails, you can read our “What Are My Burial Benefits as a Veteran” eBook here. Then, you can discuss your preferences with the preplanning specialist and ensure that your family gets access to all of the veterans’ burial benefits you’d like to receive.

5. Funding Options

With a terminal diagnosis, funding options will be more limited. The preplanning specialist can review the options that are available to you, so that you can make the decision that makes the most sense for your particular financial situation.

What’s Next?

Now that you know more of what to expect, do a little brainstorming and research in advance of your preplanning appointment. Talk everything over with your loved ones. Most of the time, the preplanning specialist can come to you, so you won’t even have to leave the comfort of your home. The preplanning specialist has experience with guiding families through each step of the process, and they won’t rush you.

One of the biggest benefits to planning ahead is that you can take your time to decide what makes the most sense for you. After everything is complete and your plan is in place, you and your loved ones will feel a sense of relief that everything is taken care of!

Dec 02

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Illustrates how an elderly woman receives hospice care at home

Where Can You Receive Hospice Care?

By Christy Kessler Hospice No Comments

If you or a loved one have been dealing with an illness for a while, the words “hospice care” may strike your heart with fear and sadness. You may feel overwhelmed or out of your element as you hear new terms and definitions, but that’s okay. Take a deep breath. You will learn what you need to know.

To help you get started, we’re going to discuss the four main places hospice care is provided, so you know what the options are and can discuss them with your hospice care team.

The Purpose of Hospice Care

Before we begin, it’s important to realize that the hospice team is designed to support and guide the family as they care for a loved one during his or her final days. Family members (and friends) are the main source of care for the patient at home, but the hospice staff is available to help with additional care needs, including pain management and symptom relief. The ultimate goal of hospice care is to allow a person to die comfortably and with dignity at home, surrounded by people they love.

Now, let’s get started.

4 Places Where You Can Receive Hospice Care

Every hospice program is designed to give you access to a team of care professionals 24 hours a day, 7 days a week, no matter where that care is provided.

In general, care is provided at your “home,” wherever that home may be. However, as your specific needs and the severity of symptoms change, the place of care may change as well. Your hospice care team can help you determine which place may be the best option for your current health situation.

To learn more about the four levels of care that hospice provides and how each level may affect where you or a loved one receive care, make sure to read “What are the Four Levels of Hospice Care?”

With that said, let’s talk about where you can receive hospice care.

1. At a Personal Residence

The most common place to receive hospice care is at a personal residence. This may mean a house, apartment, duplex, townhome, condo, etc. The hospice care team – made up of medical professionals, aides, and volunteers – will drop by for scheduled visits to check on the patient’s condition.

Most often, the hospice care team does not provide around-the-clock supervision – that responsibility falls on the family – but when needed, a hospice care member may stay for longer visits or even overnight.

2. At an Assisted Living or Nursing Home Facility

For some people, home may be an assisted living facility or nursing home. In this case, the facility may have specially trained nursing staff to care for hospice patients. Alternatively, they might decide to partner with a hospice provider in the area. For terminally ill patients who don’t have someone to care for them at home, an assisted living or nursing home facility is a good option.

A Quick Note Before We Move On

With hospice care, the primary goal is to allow a person to receive care in their own home. However, there are times when care at home isn’t enough. For these cases, you can receive hospice care at the following places instead.

3. At an Independent Hospice Facility

In some cases, your hospice provider may have its own independent facility or “hospice house.” With its home-like atmosphere, a hospice house provides a comfortable place for in-patient, short-term stays when a patient needs around-the-clock care and supervision.

For the most part, a patient may stay at a hospice house if their symptoms have worsened and cannot be managed at home or they have requested respite care to give family members a break.

4. At the Hospital

At times, it may be necessary to receive hospice care while at the hospital. Depending on how the hospital has it set up, the patient may receive care:

In a special hospice unit
From a hospice team that visits patients on any nursing unit, or
The medical staff at the patient’s current unit will act as the hospice team

Like a hospice house, there are two main reasons a person may receive hospice care at a hospital.

Either pain and symptoms have progressed to the point of becoming unmanageable at home, or
The family has coordinated respite care for a few days

The patient will return to at-home hospice care after respite care is complete or they feel comfortable enough to return home.

Remember…

Remember that you should always consult your insurance provider before making a change to the place of care. Most hospice benefits do not usually cover the cost of housing a patient in a nursing home or assisted living facility (also known as daily room and board costs), but these costs may be covered by traditional Medicare benefits or other benefits you have.

Hopefully you now have a better understanding of your options and can confidently converse with your hospice care team about your needs as they change.

Nov 17

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shows man talking to his doctor about his health

What are the Four Levels of Hospice Care?

By Christy Kessler Hospice No Comments

Every person’s life situation and illness are different. One person may have a large family that will split care duties, while another person may have one child and a close friend available to help. For one person, a terminal illness may manifest quickly while the same illness takes longer in another person.

Because situations are varied and could change at any time, Medicare (which covers the largest majority of hospice care expenses) requires that hospice care providers offer four levels of service. You may start the day at one level and be at another level later in the day as needs change, and that’s okay. Hospice programs are equipped to pivot and adjust quickly as things change.

Today, we’ll review the four levels (or “kinds”) of hospice care that are available to families.

1. Routine or Intermittent Home Care

More than likely, it is routine or intermittent home care that comes to mind when you think of hospice. With this level of care, nurses, aides, or therapists stop by the home for short, regularly scheduled visits. These visits are focused on pain management, symptom management, emotional and spiritual counseling for the patient and family, assistance with daily tasks, nutritional services, and therapeutic services.

Routine care takes place wherever the patient calls home. This could mean a residence, a skilled nursing facility, or an assisted living facility, to name a few options. Also, while visits are routine, if your family needs additional help, there’s a nurse on-call 24 hours a day.

2. Continuous Care

With continuous care (or crisis care), a hospice patient will receive nursing assistance for several hours at a time, or even overnight, during a time of medical crisis or intense symptoms. If the patient’s symptoms are severe, they will need more focused and frequent care, so the hospice worker will stay for longer periods of time.

If death is imminent, the hospice nurse may stay overnight or offer whatever support they can to the family. This type of round-the-clock nursing allows family caregivers the opportunity to step back from hands-on care and focus on simply being with their loved one.

3. In-patient Care

While it’s most common to receive hospice care at home, sometimes home nursing isn’t enough. If symptoms intensify or it’s become impossible to manage pain or symptoms at home, a hospice patient may receive in-patient care at a hospital, nursing home of their choice, or independent hospice facility (also called a “hospice house”).

The goal of in-patient care is to help a patient become stable enough that they can return home again. However, in some cases, the person chooses to spend their final days at the in-patient care facility rather than return home.

If the medical need that leads to in-patient care is related to a hospice diagnosis, your insurance’s hospice benefit will likely continue to pay the bills. With an unrelated medical issue, contact your insurance company to discuss what’s covered in your policy.

4. Respite Care

For caregiving family members, a terminally ill loved one’s physical needs can be demanding. To give family caregivers an occasional break, hospice providers offer in-patient respite care.

With respite care, the hospice patient is checked into a 24-hour personal care home. While there, the patient will receive round-the-clock care for up to 5 days. After 5 days, the patient returns home to receive either routine care or continuous care (as needed).

Though this level of care isn’t necessary for every family, it is available and covered by Medicare. Also, if your family needs respite care more than once, that’s fine, too. Just coordinate with your hospice team.

Who Determines Which Level of Care is Appropriate?

When you start using the services of a hospice provider, the hospice physician and nursing team will complete an assessment to determine which level of care is appropriate at that time. As symptoms change, the hospice medical personnel can keep tabs on the hospice patient’s status. They can adjust levels of care as needed.

However, don’t think you have to wait on the doctors to take notice. If you see a need to update your level of care, don’t be afraid to ask. Be proactive and talk to your hospice team about updating your care routine.

If you have more questions about the four levels, contact a local hospice provider and start getting answers. While there may be four “levels,” the best part is that no matter which level of care you or a loved one receive, the hospice philosophy will not change: to provide expert medical care and emotional support that respects the unique wishes of the patient. From the moment you begin a hospice care program, your family will be in good hands.

Sep 09

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Man and wife receiving a doctor's care at home

What’s the Difference Between Palliative Care and Hospice Care?

By Christy Kessler Hospice No Comments

If you or a loved one have recently entered hospice care, all of the jargon and terminology may feel daunting and foreign. For many people, two terms that often become confusing are palliative care and hospice care. Today, let’s break these two terms down so that you feel more comfortable and knowledgeable. After all, understanding what’s going on around you can help create a little bit of control in an uncertain situation.

What is Palliative Care?

First, let’s talk about palliative care and get a sense of what it provides.

Definition

In short, palliative care refers to the day-to-day care and emotional support provided to someone with a life-threatening illness as doctors pursue a cure (age doesn’t matter). In other words, curative treatments and palliative care occur simultaneously.

For example, a person dealing with a stage 4 cancer diagnosis will receive palliative care as they go through the treatments prescribed by their doctor. Palliative care begins with a diagnosis and only ends when 1) the person gets well or 2) it becomes clear that the person isn’t going to survive their illness.

Who provides palliative care?

The primary care physician oversees palliative care. When a person begins to receive care, a team is assigned to them. This team will work with the patient and their family to provide medical, emotional, physical, social, and practical support.

The palliative care team is made up of doctors, nurses, social workers, nutritionists, and chaplains (based on the patient’s needs). Each member of the team focuses on different aspects of the patient’s overall well-being and care.

What is the purpose of palliative care?

Some illnesses and treatment plans take a harder toll on the body. Palliative care seeks to enhance a person’s life by focusing on quality of life – for both the patient and their family.

Not only does palliative care focus on easing symptoms, the palliative care team also desires to help patients understand their treatment options so they can make the choices most appropriate for their specific needs.

Where can a person receive palliative care and is it covered by insurance?

Thankfully, palliative care is available at many different types of facilities. You can receive it at hospitals, nursing homes, outpatient palliative care or specialized care clinics, or even at home.

As for insurance, it’s best to check with your insurance provider, though many plans do include some form of coverage. If you are a veteran, check with the Department of Veterans Affairs to see if they might cover palliative care.

How do I request palliative care?

If you think palliative care is the best next step, your primary care physician can refer you to a palliative care specialist. However, if your doctor doesn’t mention it on their own, don’t be afraid to ask!

What is Hospice Care?

Now that you have a better understanding of palliative care, let’s compare it to hospice care.

Definition

Hospice care refers to the care provided to those who have received a terminal diagnosis (often with a prognosis of six months or less). However, an illness’s timeline can change so it’s possible to receive hospice care for longer than six months, if needed. Hospice care focuses on pain and symptom management since patients in hospice care are no longer seeking a cure.

Who provides hospice care?

Similar to palliative care, patients are provided with a hospice care team made up of doctors, nurses, social workers, nutritionists, volunteers, and chaplains (as needed) that provide a variety of services. However, hospice care is overseen by the hospice medical director rather than the person’s primary care physician.

Regardless, everyone works together to ensure that both the patient and their family are receiving the holistic care they need. The team will visit regularly and is available by phone.

What is the purpose of hospice care?

Hospice care seeks to provide care, comfort, and quality of life to the person who is dying. At this point, the patient understands that their body is no longer responding to medical treatments. The hospice care team steps in to offer comprehensive care for medical, physical, practical, and spiritual needs.

Additionally, the hospice care team provides much-needed assistance to family members and friends as they grapple with the day-to-day demands of caring for a loved one with a terminal illness.

Where can a person receive hospice care and is it covered by insurance?

In most cases, hospice care is received at the home, but it is also available at assisted living and nursing home facilities, hospitals, and hospice centers.

Both Medicaid and Medicare offer coverage for hospice care (as do most other insurance companies), but you will need to call to get the specifics of your particular plan. Again, if you are a veteran, don’t forget to check with the VA.

How do I request hospice care?

If you confer with your doctor and decide not to pursue life-saving treatments, you can start talking about hospice care. Most often, the doctor will bring it up, but if not, ask. There are some minimal eligibility requirements you can read about here.

Let’s Recap

As you can see, hospice care and palliative care are quite similar. Both involve putting together a team of qualified professionals to assist a patient and their family medically, emotionally, physically, spiritually, and practically. Both involve easing pain and symptoms related to a life-threatening condition.

The main difference between the two relates to ongoing curative treatment. With palliative care, the patient is still actively seeking a cure, while those in hospice care have exhausted all curative options and are focusing on quality of life.

With these terms defined, hopefully you will feel empowered to ask for what you need when you need it. After all, both palliative care and hospice care options are available and will offer caring support during a difficult season of life.

Aug 10

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Show funeral director helping couple through the planning process

What Do Funeral Directors Do?

By Christy Kessler Meaningful Funerals No Comments

With a loved one in hospice care, it’s possible that you may be planning a final tribute sometime in the near future. But what exactly do funeral directors do, and how can they help you? To most people, funeral service is a bit of a mystery. That’s because a vast majority of people have never had to plan a funeral. Let’s look at some of the main ways funeral directors serve grieving families during a time of loss.

Funeral directors are event planners, caregivers, and administrators. Often, they are also embalmers, caring for a loved one’s body. In many ways, funeral directors are guides to families during a very confusing and difficult time. For instance, funeral directors are there to offer comfort, advice, guidance, and insight to families during the entire funeral planning process. Here’s a look at what funeral directors do every day to serve families.

Creating a Healing and Meaningful Funeral or Memorial Service

Primarily, a funeral director’s role is to help the family create a personalized and meaningful funeral experience. A good funeral service brings healing to the grieving while honoring the final wishes of the person who has died. So, a funeral director’s main job is to help the family grieve the loss of a loved one while also ensuring that the deceased’s body is cared for with dignity and respect.

The following list covers the eight primary duties that funeral directors perform every day with great dedication and attention to detail.

1. Care for and prepare the body of the deceased for final disposition

Firstly, the funeral director will coordinate the transfer of the deceased into the care of the funeral home, day or night. Then, they will direct and supervise the work of embalmers, funeral attendants, death certificate clerks, cosmetologists, or other staff.

Preparation and care of the body may include all of the following:

- Washing of the body
- Embalming preparation
- Restorative art
- Dressing
- Hairdressing
- Cosmetology
- Casketing

If cremation is chosen, the funeral director will oversee the cremation and return the cremated remains to the family. In cases where the body must be transferred out of state, the funeral director will coordinate the transfer of the body to the final place of rest, in accordance with the applicable laws and regulations.

Finally, the funeral director will offer the family options for caskets, urns, burial liner/vault, and cemetery space, as applicable.

2. Plan the funeral with the family

Next, the funeral director will meet with the family for the arrangement conference. During this time, the funeral director can get to know the family and educate them on how to plan a healing and meaningful service.

To create a personalized service, funeral directors listen to the family and offer ideas, insights, and advice. During this time, the funeral director will share the elements of a meaningful funeral and offer suggestions for visitations, gatherings, readings, music, eulogies, symbols, and healing actions.

In addition, funeral directors incorporate funeral customs based on the family’s preferences. Personalization may include traditions of faith groups and/or civic organizations, military honors, or cultural rites and rituals.

Most funeral directors are able to offer a variety of options to suit the family’s needs. Funeral directors are there to answer any questions the family may have and help them make choices that are right for them. That way, the funeral or memorial service brings comfort and peace to all who mourn the loss.

3. Coordinate all the details behind the scenes

In addition to helping the family plan the funeral experience, funeral directors perform various duties behind the scenes. For example, funeral directors usually:

Prepare and submit obituary information to media outlets as needed
Help the family coordinate with clergy or celebrants, a venue for the service, and musicians
Ensure that clergy or celebrant and musicians know where to be when and that they receive an honorarium for their time
Help order funeral sprays and other flower arrangements as the family wishes
Ensure that the funeral, memorial, and/or graveside service venues are properly prepared
Coordinate any cremation or burial processes
Make sure that the funeral service is streamed live or digitally recorded, if the family wishes
Provide additional memorialization products; for example, a register book, prayer cards, acknowledgment cards, and funeral folders
Coordinate a police escort for the funeral procession
Handle all memorial contributions presented to the family

4. Take care of permanent memorialization needs

Next, the funeral director helps the family consider permanent memorialization needs. For instance, they may discuss options such as a cemetery plot, columbarium niche, plaque, grave marker, deciding on where to scatter ashes, and more. As part of their role, the funeral director will help you review your options and choose what fits best for your family. Then, they will help with the details. A funeral director will:

Schedule the opening and closing of the grave with cemetery personnel
Help the family choose a casket, urn, burial vault, and cemetery plot
If scattering is chosen, they will offer location options and suggestions
For a graveside service, they will:
- Provide transportation for the remains, primary mourners, and flowers between sites
- Coordinate with the cemetery to prepare and decorate the site for the service
Make sure gravestones or grave markers are ordered and placed in the cemetery

5. Assist with legal documentation

After losing a loved one, there are a lot of legal documents to complete and file with the state or federal government. However, the funeral director will take the lead on some of this documentation, ensuring that everything is taken care of as needed. For instance, the funeral director will:

Submit documentation for an official death certificate
Help the family obtain certified copies of the death certificate
Request cremation or burial authorization documents and permits
Explain the benefits available through Social Security or the Veteran’s Administration
Assist with submitting claims for prepaid burial plans, insurance policies, or annuities on behalf of surviving family members
Stay informed on any policies, regulations, or laws to ensure that funeral service operations are in compliance

6. Share grief resources

After the funeral or memorial service, the funeral director may continue to check in with the grieving family to see how they are doing. As the funeral director listens to and assesses the family’s needs, they may:

Provide grief assistance and grief resources
Connect the families and friends with local grief counselors
Share support group activities in the area

7. Help families plan ahead

While most of a funeral director’s responsibilities occur after a loss, not all do. For instance, they do often help families record funeral wishes ahead of time. Planning ahead for funeral wishes can be extremely helpful to loved ones. The more your family knows about your final wishes, the easier the funeral planning process will be after you’re gone. At the time of loss, many families are plagued by the question, “Did we do the right thing?” It would be so much easier if they knew exactly what you wanted. This is why funeral directors actively work with families to create a written plan that will benefit surviving family members. The funeral director will:

Ask questions about your wishes
Determine whether you prefer cremation or burial
Review casket, urn, and grave liner/vault options
Go over permanent memorial options
Share the benefits of having a healing and meaningful service
Brainstorm ways to personalize the funeral or memorial service
Gather vital statistics information
Review veterans’ burial benefits, if applicable
Discuss payment options (if you would like to pay in advance to save your family from the expense in the future)
And more!

8. Run a small business

Lastly, a number of funeral homes are family-run businesses, and funeral directors may need to wear a few different hats. When they aren’t assisting families, the funeral director may need to:

Work with various vendors such as florists, caterers, and cemeteries to fulfill the family’s wishes
Submit death certificates to the state
File necessary documentation and permits
Complete billing, bookkeeping, and payroll duties
Keep accurate records of inventory
See to any last-minute details for the family
Other duties to keep a small business running

As you can see, funeral directors do quite a lot. While there may be some things you’d like to do yourself, the professionals are there to take care of you! They know exactly what is needed and can make everything a little easier.

*NOTE: This article seeks to list the vast majority of the responsibilities of a funeral director, but it’s not comprehensive.

Jul 08

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Woman standing next to casket while holding white lilies

Simple Ways to Personalize the 7 Elements of a Funeral

By Christy Kessler Meaningful Funerals No Comments

With a loved on in hospice care, you may feel a little overwhelmed with the idea of planning a funeral or memorial service. That’s okay. So many of us have never planned a funeral before and simply don’t know where to start. To help grieving families, Dr. Alan Wolfelt, a nationally respected grief author and educator, has identified 7 elements that create a meaningful and healing funeral or memorial service: music, readings, viewing/visitation, eulogy, symbols, gathering, and actions. When you personalize these elements, you can create a funeral experience that will touch hearts and meaningfully celebrate someone loved.

Grandmother hugging grandson, both smiling

The most important thing to remember is that personalization is key. The more personal a funeral or memorial service is, the more healing and meaningful it will be. Dr. Wolfelt says, “Focus on what is really important—what is essential—about the funeral you are planning.  What is essential is the life that was lived and the impact that life had on family and friends.  To honor that unique life, the funeral must also be unique. Over and over families tell me that the best funerals are those that are personalized.”

Let’s review the 7 elements and discuss ideas for personalizing each one.

Music

First of all, music sets the tone of a funeral or memorial service and brings emotions to the forefront. In fact, one of the purposes of a funeral is to allow mourners to grieve together, and in many ways, music says what words cannot. We often shy away from our emotions, but don’t be afraid to invite people to express their grief. Consider using music as an avenue to bring out what people are thinking and feeling.

How to Personalize:

Choose songs that were significant to your loved one, no matter their musical genre
Consider whether you want music performed live or if you prefer to use recordings
If you have musical family members, you might ask them to play a tribute song
For those who are religious, choose appropriate hymns or praise songs

For a few more ideas, please read Top 10 Hymns for a Funeral Ceremony, Top 10 Songs for a Funeral Ceremony, Top 12 Country Songs for a Celebration of Life Service, and Why Include Special Music in a Funeral Ceremony?

Readings

Second, readings add another facet to a meaningful service. They are another way to invite mourners to express their emotions while also honoring the unique spirit of your loved one. Have you ever heard a poem, lyrics, or movie quote that really spoke to you? These can easily be used as a reading and can add a deeper dimension to the service.

How to Personalize:

Use quotes from favorite books, plays, movies, or TV shows
For a person of faith, read passages from an appropriate holy book
Consider reading special poems or quotations
Read a letter you have written to your loved one
You could use your loved one’s own writing or incorporate catchphrases they were known for
If you are planning ahead, consider writing a message ahead of time to be read at the service

For additional ideas, check out How Do Readings Enhance the Funeral Experience or Top 10 Poems for a Funeral Ceremony.

Viewing/Visitation

Third, the viewing or visitation is a time for family, friends, coworkers, and neighbors to gather and express support and sympathy. If you choose, a viewing creates an opportunity for mourners to see this special person one last time and begin to acknowledge the reality of their death. For many, as part of the grieving process, it is important to physically see the body. The viewing offers this opportunity. However, a family can choose to simply have a visitation, which is a set aside time to gather and receive support from caring friends and family without the body present.

The viewing and/or visitation offers a special time for personalization. Whether the body is present or not, this is a time to tell a story – the story of a lifetime.

How to Personalize:

Display photos, mementos, or items associated with a hobby or interest (books, artwork, ceramics, model planes, etc.)
Invite guests to write down a memory on provided notecards (the family can enjoy them later)
Provide a keepsake token to take home (a book, a favorite recipe, etc.)
Create a memorial work of art, like a thumbprint tree
Bring a photo book or your loved one’s favorite book and ask people to write notes inside
Create a slideshow to play during the event

Eulogy

Fourth, the eulogy may be the single most important aspect of a funeral service. It’s important to take care and spend concentrated time deciding what you want to say. After all, the eulogy is the time to acknowledge and affirm the significance of the life lived. The eulogy, sometimes called the “remembrance” or the “homily,” can be delivered by a clergy person, a family member, or even by a series of people.

How to Personalize:

Share memories, quotes, or even a loved one’s favorite jokes
Tell a significant and meaningful story about the person who has died
Bring visual aids (like an item the person carried or were known to cherish)
Share something the person taught you and how they impacted your life and the lives of others

For more helpful ideas, please read What is a Eulogy and Crafting a Eulogy.

Symbols

Fifth, symbols are an important aspect of a funeral because they convey love and comfort, facilitate expression, and offer a focus point for the grieving. For instance, we send flowers or bake casseroles to convey the love we feel and the support we offer.

For one grieving family, an appropriate symbol was the quilts their grandmother made. Before her death, she made a quilt for every child and grandchild, and at her final tribute, the quilts were displayed on the pews – a representation of her love and impact on her family. Common symbols are an appropriate religious symbol, flowers, dark clothing, and candles, but you can use whatever feels best to honor your loved one.

How to Personalize:

If appropriate, ask everyone to wear your loved one’s favorite color to the funeral
With traditional burial, the body and casket are the ultimate symbol or focal point
With cremation, a symbol might be an urn, a portrait, or some other appropriate item
If they were a person of faith, include religious symbols to offer comfort
If they were known for something (like quilts), turn those items into a symbol

Gathering

Sixth, the gathering is an opportunity for friends and family to come together after the funeral service to share stories and to support each other. This event may occur at the funeral home, an event center, someone’s home, or even a local restaurant. The point of a gathering is to bring people together directly following the service to share stories, remember a loved one, and connect (or reconnect) with people.

In many ways, the gathering is another excellent place for personalization because you may have more time and a lot of space to work with.

How to Personalize:

Have the gathering at your loved one’s favorite restaurant
Choose a venue that means something (for example, a church, local country club, beach, park, etc.)
Serve your loved one’s favorite foods
Display photos, cherished possessions, and mementos
Decorate with your loved one’s favorite colors
Include a set aside time when friends or family can publicly share special memories
Create a memorial work of art together or plant a memorial tree

Actions 

And finally, by inviting others into action at the funeral service, you engage mourners and invite them to put their grief into motion. Simply put, mourning is the outward expression of our inward grief. To move others toward healing, it is important to invite them to act.

How to Personalize:

Participate in a release ceremony (biodegradable balloons or lanterns, doves, etc.)
Incorporate keepsake items
Invite mourners to write down memories on note cards
Ask family and friends to bring photos they have of your loved one to add to a group collage
Set a theme that invites attendees to wear your loved one’s favorite color or style of clothing (i.e. Hawaiian shirts, sports jerseys, etc.)
Light candles of remembrance
Ask people to take part in the service as eulogists, readers, singers, musicians, or pallbearers

Hopefully, these thoughts will spark ideas of your own. Ultimately, planning a funeral or memorial service that accurately reflects your loved one’s life, passions, values, and beliefs creates an opportunity to specifically and meaningfully remember, honor, and celebrate their life.

As you consider how you can incorporate these 7 elements into a funeral or memorial service, remember that you aren’t on your own in this. The funeral home has caring and experienced staff ready to help you with all your questions and concerns as you create a moment in time that can bring peace and comfort for years to come.

Jun 22

Love0

Man looking out window, friend places comforting hand on shoulder

Self-Care Recommendations When Someone You Love is Dying

By Christy Kessler For Caregivers & Families No Comments

If you have a friend or loved one who is dying, you’re likely dealing with a lot of feelings right now: sadness, shock, disbelief, anger, anxiety. It’s normal to experience these emotions, and you have every right to feel the way you do. As you juggle your own grief with the need to be there, physically and emotionally, for your friend or loved one, you will need to care for yourself and realize that you can’t do it all on your own. Below, we will discuss 6 self-care recommendations that will help you tend to yourself and stay emotionally stable as you care for your friend or loved one in their final days.

1. Share Your Feelings

Someone you care deeply about is dying and will soon be gone. Odds are, you will also need support as you explore your own feelings about this illness and the changes you see in your friend or loved one. Find someone who will listen to you without judgment as you talk out your own feelings. To stay available to your loved one, you need to be able to work through your own feelings. Do this with someone you trust.

Grief support group with five people

Additionally, many hospices offer support groups for friends and family of the dying—both before and after the death itself. Take advantage of these compassionate resources.

2. Care for Your Body

Visiting or caring for a terminally ill person will zap a lot of your energy – both mental and physical. To make the most of the time you have left with your loved one, you need to make sure you aren’t running yourself ragged. Make sure to eat nutritious meals. Get plenty of rest. Continue to exercise. Spend time doing things that make you happy. Take a break from the sick room.

Nutritious meal with grilled chicken, tomatoes, and green salad

If you’re a primary caregiver, it may feel counter-intuitive or just plain wrong to take time away for self-care or to enjoy simple activities, but you will need these times to help you stay afloat. No one can sustain continuous stress, anxiety, and sadness without starting to crack. Adding a few self-care habits will help you keep it together and have the energy you need to be fully present with your loved one. Self-care has become more and more valued in our society, so make sure to take the time to do it.

3. Realize Your Own Limitations

It’s important to realize that not everyone can offer ongoing support to someone who is dying. If you feel you simply can’t cope with the situation, try to understand your reticence and learn from it. Ask yourself, “Why am I so uncomfortable with this?” and “What can I do to become more open and compassionate in times of need?”

Do not, however, avoid your friend or loved one altogether. Phone rather than visit. Write a letter or email if you can’t bring yourself to phone. Let them know that this situation is difficult for you while at the same time acknowledging that your friend or loved one’s fears and needs come first.

On the other end of the helping spectrum, don’t become obsessed with the illness or feel that you must be your loved one’s only means of support. Do not emotionally overburden yourself.

4. Establish a Routine

After a terminal diagnosis, everything may feel out of control. Your routine is upset. You are suddenly dealing with events, people, and emotions you didn’t expect. Your life has lost its normalcy and has been thrown into disarray. By establishing a routine, you can begin to gain back some of the normalcy and control you lost. When you feel comfortable in your routine, you can begin to process what’s happened and learn how to deal with and manage your feelings.

Man writing in day planner

Additionally, establishing a routine will help your dying friend or loved one. They also need structure to rely on, as their life has been thrown into just as much, if not more, disarray than yours. If you are a close caregiver, establish a routine together. If you are more on the periphery, make sure to communicate your wish to visit on a regular basis and find a time that works best for both of you.

5. Embrace Your Own Spirituality

If faith is part of your life, express it in ways that seem appropriate to you during this difficult time. Pray with your friend or loved one and with their family. Allow yourself to be around people who understand and support your religious beliefs. Read spiritual verses or poems. Sing songs. Find the comfort that your faith can bring to the hard seasons of life.

Woman praying in a religious building

If you are angry at God because of your loved one’s illness, that’s okay. Find someone to talk with who won’t be critical of whatever thoughts and feelings you need to explore. It’s normal to have questions or doubts when faced with death, but as you embrace your own spirituality, you will find the answers you need.

6. Seek Hope and Healing

As much as you may not want to face it, in time, your friend or loved one will die. To love and live wholly again, you must find a way to mourn. In fact, you cannot heal unless you openly express your grief. Denying your grief, before and after the death, will only make it more confusing and overwhelming. As painful as it may be, you must embrace your grief in order to begin to heal.

Dr. Alan Wolfelt, a nationally recognized grief counselor and author, puts it this way: “You might fall into the common thinking of our society that denying these feelings will make them go away. You might have the urge to ‘keep your chin up’ and stay busy and wait to ‘get over’ your grief. Yet, ironically, the only way to help these hard feelings pass is to wade in the muck of them. To get in and get dirty. Grief isn’t clean, tidy, or convenient. Yet feeling it and expressing it is the only way to feel whole, once again.”

Reconciling your grief will not happen quickly. Remember, grief is a process, not an event. Be patient with yourself. Never forget that the death of someone loved changes your life forever.

With these 6 self-care tips in mind, start choosing the best ways to maintain your own self-health while supporting your dying friend or loved one. More than likely, you will still be tired and emotionally worn. However, these recommendations for self-care can help prevent you from reaching burnout as you journey alongside someone you love during their final days.

*Based heavily on a brochure by Dr. Alan Wolfelt. Dr. Alan Wolfelt is a respected author and educator on the topic of healing in grief. He serves as Director of the Center for Loss and Life Transition and is on the faculty at the University of Colorado Medical School’s Department of Family Medicine. Visit www.centerforloss.com to learn more about helping a friend in grief. Published with permission.