Your care recipient will survive your absence for this short period, and will gain from it in the long run — as you will return to your responsibilities with a lighter heart and clearer mind.  It’s a win-win for everyone involved.

OK.  Maybe the doctors are right about how good exercise is for you.

Ruth Frith was the oldest female athlete participating in the World Masters Games in Sydney earlier this month.  Not only did she win the gold medal in the shot put competition, but she also set a new world record with her 13 feet, 4.2 inches throw (4.07 meters).

Did I mention Ruth is 100 years old?!

The great-grandmother of 11 is also a hammer and javelin thrower and believes other seniors should follow her example.

Frith trains five days a week, regularly lifting 35 kg (77 lb.) weights.  She doesn’t drink or smoke and she doesn’t eat vegetables either, claiming she hasn’t liked them since she was young.

Frith was one star of the World Masters Games — an event which attracts about 28,000 athletes — and despite her age, said she has no plans to retire just yet. She competed in her first World Masters Athletics Championships at the age of 74.

The oldest male competitor was Reg Trewin, age 101, who competed in lawn bowling.  And Ralph Howard, the gold medal winner in rowing, is 91 and has been rowing for 75 years!

The World Masters Games have been held every four years since they began in Toronto in 1985.  Open to people of all abilities and most ages, the games are the world’s largest multi-sport event, attracting twice as many competitors than the Olympic Games, according to the website (www.2009WorldMasters.com).

The main difference between the World Masters Games and the Olympic Games is that World Masters are open to people of all abilities rather than just elite athletes, with the emphasis on participation. I love the Games motto:  “Fit, Fun and Forever Young.”

My hat’s off to Ruth Frith, a Gold medal winning Golden Oldie!

Does this inspire you to exercise more . . . or to at least begin an exercise program?  To take up a new sport?

Do you think it would inspire the Golden Oldies in your life to exercise or be more physically active in some way if you share this story with them?  Please comment below.

This article is Part 4 in a series on hospice care.  Please see the section below entitled “Related Posts” for links to Parts 1, 2, and 3 and to read more on this topic.

First Time Around It Was “No Go”

I was impressed with the way my dad’s final months were made more comfortable physically and emotionally via hospice care, as well as by the support I received from them. I wanted my mother to receive this same comfort care.  She was already in the middle stages of Alzheimer’s disease when my dad passed away, and I knew I really didn’t want to subject her to any more hospital stays in her lifetime, so placing her on hospice care was the answer for me.

I asked the hospice company to assess her, assuming they’d admit her to their service.  Wrong!  The hospice company told me she didn’t meet the strict criteria for admittance as a patient.  In one way I was glad that she didn’t qualify for hospice but, on the other hand, I was somewhat surprised and let down.  While disappointed, I learned their parameters, and also knew it was only going to be a matter of time before she would meet the criteria.  And in April of 2007, she did.

A Different Experience Due to Length of Time on Hospice

The difference between my mom’s and dad’s hospice experiences was due for the most part to the length of time they each received hospice care.  It was provided by the same hospice company, but my father was on hospice less than six months, while my mother was on hospice for approximately two years.

As a result of her extended time on hospice and her continuing decline, she utilized these additional services:

• The hospice company provided more medical equipment for my mom:  a hospital bed with an alternating pressure air mattress, a wheelchair, incontinence supplies, and a medical hoist to help the caregivers lift her from her bed to wheelchair and back again.

• The hospice company consulted with wound care specialists several times who assessed and suggested alternative treatments for the bedsores that appeared despite the excellent care she received. (Yes, bedsores can develop even when patients are very well-cared for. Read more about this subject here.)

• A dedicated hospice volunteer visited my mom once a week and helped my mom participate in arts & crafts or music as much as she could, read books to her, talked with her (even though it was pretty one-sided due to mom’s aphasia), brought flowers and little gifts, and just kept her company if she was sleeping.  These “quality time” visits were greatly appreciated by me, since I couldn’t be there every day.  The volunteer also got to know our whole family and we still are in touch months after my mom passed away.

• When my mom experienced her first ever tonic-clonic seizure, continuous care was provided by hospice for about the next 48 hours.  This means hospice staffers gave her intense around-the-clock care until she returned to “normal.”  This was only offered by hospice as a short term level of care and reevaluated each day, because it is also based on strict Medicare guidelines.

Caregivers vs. Hospice Staff in “Territorial Wars”

An interesting thing occurred during the treatment of my mom’s bedsores.  The board & care caregivers and the hospice RN’s pointed fingers at each other a few times, insinuating that it was the others’ fault that my mom’s bedsores weren’t healing quickly enough.  The caregivers felt the RN’s needed to provide more frequent wound care; while the hospice RN’s felt that the in-home caregivers didn’t turn or reposition my mom often enough since she was bedridden.  It was subtle verbal warfare that I heard both sides of.  Although it didn’t became a big brouhaha, and never went further than a few words spoken privately to me on occasion.

It’s important the staff of the board & care and the hospice nurses easily co-exist and communicate well with each other.  And they should not get into “territorial” wars over who the patient is getting “better” care from.  I knew they all wanted what was best for my mom, but they needed to stay focused on that and not start pointing fingers out of their frustrations over the bedsores.

If you notice this phenomena occurring during your loved one’s care and it’s getting to be more than you want to deal with, contact the hospice team manager and/or board & care administrator and let them get it ironed out.  With mom’s medical condition I believe her bedsores were lingering for any number of reasons, and I never blamed the caregivers nthe RN’s.  All of us were a “village” providing the best care possible for my mom.  Your family could find themselves in the middle of staff turf wars, too, over various caregiving issues, so please be aware.

More Lessons Learned from The Two Hospice Experiences

As I wrote previously, I might have interviewed other hospice companies if I had known in the beginning there were different types to choose from.  Some time after the first year of my mom’s hospice experience, I decided to interview a smaller “mom and pop” type of hospice company a close friend (who is also an RN) recommended.  One benefit was that the nurses’ caseloads with that company were  smaller, so their patients theoretically could receive more frequent or longer visits.  This benefit appealed to me and I thought over the pro’s and con’s of each company for several weeks.

I decided to stay with our original hospice company.  I didn’t want to invest the additional time and energy it would take for a whole new team of hospice workers to get to know and initiate care for my mom.  I realized no hospice company is perfect and it just didn’t seem worth it to make a change at that point.  It turns out this decision to keep the status quo was just a few months before my mom died, and that fact made it an even better decision in hindsight.

Every hospice patient and their family’s experience depends greatly on the individuals on the hospice staff.  Although the doctors, RN’s, social workers and home health aides that cared for my parents were all employed by the same company and therefore had the same goals and philosophy, they each brought their own personality and style to the job.  These can vary greatly and the patient’s family should be sure the staff’s style of communicating and caregiving match what you perceive your care recipient’s and your family’s needs are.

For example, the social worker assigned to my dad’s case was a treasure.  As I wrote in a prior post, she met me in person at the board & care several times and checked in by phone with me regularly to offer support to us on a continuing basis.  When my mom was admitted to hospice two years later, I was pleased to learn the same social worker was assigned to her case.  Later on she left the hospice company and the new hospice social worker approached her job very differently.

This new social worker never called to introduce herself nor made any contact with our family until I called the hospice company with a question that fell under her bailiwick.   She then promptly met me at my mom’s board & care and provided the needed information, but the “connection” and compassion I felt immediately from the prior social worker was missing.  Yes, she technically fulfilled her job duties by efficiently responding to my query, but that was it.  She seemed harried and her demeanor just wasn’t a good fit with mine.  If I needed more help from the social worker, I would have requested someone else on the hospice staff.  Like any paid service, we as consumers have the right to ask that our basic needs be met.

I recommend patients and their families be open to the concept of hospice care.  It is a scary word associated with death and hard to face, but it provides a positive end-of-life option.  Learn about it. Interview local hospice companies before making a decision on which one to use.  Talk with your aging parents about their end-of-life thoughts, plans and desires. Educate your whole family about this phase of life and how hospice can help manage so many facets of it.

I feel very fortunate that both of my parents were able to die with no pain, peacefully and with dignity.  I wish everyone could leave this world in that way.  Don’t you?

If you or your loved ones have had experience with hospice care, please share with us in the comment section below.

And check back soon for more articles in this series.

I could try to write a post about hospice and therapy dogs, but no words I write would come close to illustrating the intertwined human and dog worlds that are revealed in this beautiful video.

Kleenex Alert — this is sure to touch your heart!

If you have trouble viewing the video, click here.

Baxter has been referred to as the “Angel of Hospice” and the world’s greatest therapy dog and I can clearly see why.

Learn more about Baxter at his website Moments with Baxter.

Update 10/17/09: I’m sorry to have to share with you the message I found posted on Baxter’s Facebook profile today:

“Baxter, the world’s best, most devoted, and oldest therapy dog, 19 years and 6 months, eased peacefully from his life on Friday afternoon, October 16th.”

My heart goes out to Baxter’s loving family.  I am so sad, yet very glad I got to “know” him, even if from afar.  He is sure to be an inspiration to others for many years to come.

If you are concerned about seniors (or “Golden Oldies” as I call them) and their pets, here is an article I wrote about what to do if your Golden Oldies may not be able to care for their pets any longer.

This is Part 3 in a series on Hospice Care.  To read the first two parts, please click on the links under “Related Posts” below.

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To everyone in the TLeC community, have a great weekend!

Please be aware I am not a health care worker, nor an expert on hospice and end-of-life issues, but I am sharing my family’s hospice experiences with you in the hope it will lead to more knowledge and a greater understanding of this aspect of life.

This is Part 2 in a series on hospice care.  You can read Part 1 here.

Admission to Hospice Care

I probably shouldn’t have been surprised when the board & care administrator suggested Dad be evaluated for hospice care.  It was just after his 98th birthday after all! While he was in above average shape for someone that old, he had deteriorated physically and mentally in the preceding weeks.

Plus the administrator actually listened to my words and my true but unspoken desires underlying the words I’d said in the months prior: “I don’t want my father to ever be put in a hospital again.”

Why did I feel this way?  Two years before I’d witnessed how confused and agitated being in the hospital and medications made him when he had hip replacement surgery.  And I didn’t want him to go through that mental angst and the physical discomfort hospital stays usually cause in the elderly.

Not every senior is placed on hospice just because a family member asks for an assessment.  A nurse examined and interviewed us both as one part of the admission process to see if my dad met the eligibility guidelines.  My dad’s doctor did an examination, as did the doctor affiliated with the hospice company.

Hospice doesn’t pay for all of your loved one’s medications, but it did cover all medications relating to the diagnosis hospice gave him, end stage cardiovascular disease. My father wasn’t taking much medicine at all, so the cost for the non-covered medication wasn’t a financial burden for us.

I eventually saw how much the hospice care bills were, and they were very expensive, but at no out-of-pocket cost to us — except for the monthly Medicare premium taken out of his social security check.   Payment for hospice services is covered through Medicare and most Medicaid programs. Most, but not all, private insurance programs offer a hospice benefit. It is important to research whether your health insurance coverage offers hospice benefits and determine exactly which services are included. Some hospice companies will help you with this analysis, too.

I didn’t interview more than one hospice company.  I just went with the one that the board & care recommended.  I didn’t realize I could have chosen any one I wanted to, but I liked the people I met through this hospice company and my instincts said to proceed with them.  I wasn’t disappointed.  As time went on and I learned more about hospice, I became aware that all hospice companies are not alike.  I happened to select a large, nationwide hospice company, however there are smaller, “Mom and Pop” types of hospice companies as well.

If I was going to do it all again, I might have interviewed more than one company just to get a feel for the various staff members, as well as to compare and contrast their approach to our family’s situation.  A hospice company is only as good as its staff makes it.  Like any service you are paying for (even if Medicare is picking up the tab in this case), make sure they provide good customer service and you are very satisfied with the patient care.  If not, look around until you find a hospice company that is a better “fit” for you and your Golden Oldies.

What Does Hospice Do When Your Loved One Already Lives in a Board & Care?

Hospice provided another entire layer of care for my dad.  There was a wonderful RN who would visit and examine him thoroughly two or three times a week.  A home health aide came every other day to bathe, shave and attend to any personal care he needed.  This was above and beyond the regular caregivers’ daily assistance in the board and care.  The RN would call me with periodic reports by phone about my dad’s condition and I was able to reach her (or her supervisor) whenever I had questions or concerns. There was also a detailed log book about my Dad recording every statistic about his health condition and medicines, contact information, and a detailed report for every visit made by each hospice team member.

Beyond patient care, phone calls were made to me on a regular basis by the hospice social worker, whom I also saw sometimes while visiting my dad.  She would call me every few weeks just to check in and see if I had any questions  or needed emotional support in any way.  The hospice company also had a chaplain who contacted me within a week of my dad’s admittance but I let him know we already had wonderful clergy to help us with religious and spiritual issues.  The hospice team (MD, RN, home health aide, social worker, chaplain, team manager) meet on a weekly basis in their offices to discuss each patient and update their care plan.

Hospice Philosophy

The goal of hospice care is to keep your aging parents comfortable and to maintain a decent quality of life while they are in their final stage of life. This philosophy is different than traditional medicine, in which health professionals strive to cure a person’s disease. Hospice services are not intended to speed up or prolong the dying process, but focus instead on relieving pain and other symptoms. Hospice caregivers are concerned with enhancing the quality of remaining life by keeping seniors as alert and comfortable as possible in a familiar environment with family and friends nearby.  Hospice care also helps family members manage the practical details and emotional challenges of caring for a dying loved one.

In Part 3 of this series, I’ll share more with you about my family’s experiences with hospice and what I learned during my mom’s final months.

Outside Resources:

The Hospice Foundation of America

Medline Plus about Hospice Care (A service of the U.S. National Library of  Medicine and the National Institutes of Health)

American Cancer Society