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When A Residential Care Community Is An Option for Temporary Hospice & Palliative Care

Hospice is not a place. Hospice is a “concept of care” designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments.1 The goal of hospice care is to provide patients with comfort and dignity at the end of life with a special emphasis on controlling pain and discomfort and managing symptoms. The focus is on compassionate caring not curing. Hospice care neither hastens nor prolongs life, but this specialized service has been shown to increase quality of life. Hospice is covered by Medicare and Medicaid and most private insurance companies to eligible patients referred by a physician. Hospice services include care by professionals and volunteers and medication, equipment, and medical supplies. Families have no out-of-pocket expenses other than the cost of room and board. The patient and family are at the center of hospice care. The hospice team works with the patient and family to develop a personalized plan of care that respects the individual’s end-of-life wishes. A multi-disciplinary team of physicians, nurses, home health aides, social workers, therapists, spiritual counselors, bereavement counselors, and volunteers provides expert and compassionate care that is available 24 hours a day, 7 days a week. Physicians and nurses are specially trained to address pain and manage symptoms. The team works closely with family members to provide feeding, bathing, turning, administering medications, and monitoring changes in a patient’s condition. Some hospice providers provide alternative therapies such as Pet Therapy or Music Therapy. Spiritual counselors, therapists, and social workers help patients and families with emotional and spiritual concerns and provide bereavement support to family members after a loved one has died. Most people choose hospice care in their own homes, but hospice care is also available in hospitals, nursing homes, and residential care communities for the elderly such as assisted living communities and board and care homes. In 2011, 66.0% of hospice patients received care in the place they call “home,” including private residences (41.5%), skilled nursing facilities (17.2%), and residential communities (7.3%).2 When hospice care is not an option at home, nursing homes, freestanding hospice facilities, and residential care communities like board and care homes are places for families to turn for short-term respite or longer term care at the end of life. The Board and Care model, which provides residential care for fewer residents in a private home, offers a home-away-from-home in an intimate environment that provides a home-like routine and a place for family to gather. Board and Care homes can offer temporary hospice to residents and families who request it. These homes typically work with a number of hospice organizations to provide families with choice for high quality care. The board and care staff coordinate care with the hospice staff and they may provide bedside comfort tailored to the resident’s needs and preferences, such as soft music, reading, and aromatherapy. “Choosing a hospice to care for yourself or a loved one in the final months or even days of life is an important and stressful process,” said J. Donald Schumacher NHPCO president and CEO. “Each hospice offers unique services and partners with specific community providers – so it’s important to contact the hospices in your area and ask them questions to find the one with the services and support that are right for you.”3 For additional information on hospice and how to select a quality hospice provider, families may turn to online resources found at the National Hospice and Palliative Care Organization (www.nhpco.org) and the Hospice Foundation of America (www.hospicefoundation.org). References: 1Hospice Foundation of America. www.hospicefoundation.org. 2Facts and Figures: Hospice Care in America. 2013 Edition. National Hospice and Palliative Care Organization. www.nhpco.org. 3Choosing a Quality Hospice. National Hospice and Palliative Care Organization. www.nhpco.org.   Trina Duke, Master of Science in Gerontology Concierge Gerontology Services
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What you need to know about Dementia

Dementias are degenerative disorders that develop primarily in the nervous system and selectively damage particular areas of the brain. Some dementias, like Alzheimer’s disease affect all areas of the brain simultaneously, while others, such as frontotemporal dementia, affect the parts of the brain involved in controlling one’s communications and emotions. Still others are caused by vascular disease, brain trauma, or chronic alcohol abuse (Korsakoff’s syndrome) By 2030, 20% of U.S. population will be older than 65 years of age – about 50 million people. Dementia affects 1% to 6% of those older than 65, and between 10% and 20% of those older than 80 years of age. In the next 30 years, estimated 10-20 million seniors in U.S. will have mild to severe forms of dementia. Seniors with history of moderate traumatic brain injury (TBI) have a 2-3 times greater risk of developing Alzheimer’s disease – those with a severe TBI have a 4-5 times greater risk. Even healthy seniors are at risk for falls and head trauma, so any fall to the head, however minor, should be seen by a medical professional and documented. Alzheimer’s disease accounts for 65% of all dementias. There is no direct diagnosis of Alzheimer’s – and while PET scans and other imaging techniques are being studied, none have yet been able to show the presence of Alzheimer’s disease. Alzheimer’s onset often surprises families because vision, movement, and sensation remain untouched while a senior’s memories begin to slowly decrease. Recent memories are affected first, leading to “senior moments” that appear innocent because all other memories, including those from decades ago, remain intact. Eventually those remote memories begin to fade, and lastly the senior’s “crystallized” memories, such as family member’s names and faces, are compromised.   By David L. Raffle, PhD Clinical and Forensic Neuropsychologist www.RaffleBrainInstitute.com
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What is the Difference Between A Large Assisted Living Facility And A Smaller Board and Care Home?

Our assisted living facilities in Los Angeles feel like home. Most people are unaware of the key differences between a large assisted living facility, which may house 150 or more residents, and a smaller board and care home. Understanding these differences is essential to making the right choice for your loved one.
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