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Could Your Loved One Benefit from Hospice Services?

Caregiving - Hospice

First and foremost, it is important to understand what hospice care is. The purpose of hospice is to provide the highest quality of care and comfort to those who are chronically ill, terminally ill, or seriously ill and to relieve or lessen the discomfort they may experience. 

Bonnie and Diana Elevation Hospice

Bonnie B. and Diana C. with Elevation Hospice

For those wondering if their loved one could benefit from hospice, Bonnie Bechek, an experienced hospice RN with Elevation Hospice, suggests to look for the following signs:

  1. Health changes, including incontinence
  2. Increased frequency and severity of falls
  3. Loss of appetite or unexplained weight loss
  4. Loss of strength
  5. Increase in sleep
  6. Mental changes
  7. Requiring more assistance in activities of daily living
  8. Increased need for medication to control pain and discomfort

Did you know?

The hospice benefits, which are covered 100% by Medicare, include:

  1. On-call nurse available 24 hours a day
  2. Management of pain and other symptoms
  3. Personal care, homemaker services, companion care
  4. Spiritual and emotional support – Social Work and Chaplain
  5. Incontinence and catheter care and medical supplies (briefs, wipes, etc.)
  6. Durable Medical equipment (wheelchair, etc.)
  7. Medications for pain and discomfort
  8. Respite care, wound care, and bereavement support

Being Mortal by Atul GwandeBonnie also recommends the book Being Mortal by Atul Gwande to all family caregivers who have a loved one needing hospice care. This book is Atul’s personal meditation on how we can better live with age-related frailty, serious illness, and approaching death.

Personal care agencies, like Aspen Senior Care, work hand in hand with the top hospice agencies to ensure our clients are receiving the care they deserve. Contact us at 801-224-5910 to learn more today.

 

 

Top 5 Signs Your Senior Loved One Needs In-Home Care

Dementia Orem, Utah

Seniors don’t often call saying they need in-home care. Many times they don’t realize they need additional help, and often they don’t even know it’s available. Usually one of their children seeks services because they’ve been helping their senior loved one and have noticed their needs have grown. Other times these adult children live out of town and come for a visit and are surprised by a few things going on in their parent’s home.

So, what are the signs that your elderly loved one might need some assistance at home? Here are the top signs we see:

1.  The house is no longer clean and organized like it used to be.

Common household chores can become overwhelming and tiresome. The vacuum becomes heavy and a pain to use for many aging seniors. Sometimes their eyes don’t see the dust and dirt like they used to. Other times your aging parents just don’t have the energy to keep up with the cleaning.

2.  You notice that medications are not being taken as they should. 

Photo courtesy of Pixabay (27707)

Photo courtesy of Pixabay (27707)

They say that one out of every two seniors over 80 has some type of dementia or memory loss. Even without dementia, it can be hard to remember to take your medications day in and day out, especially if someone is not filling pill boxes every week. Days blend with other days and important medications get missed.

3.  The fridge has minimal or spoiled food and the freezer has a lot of frozen foods.

Many times seniors start turning to easily prepared foods and frozen dinners. I remember one family whose parents were surviving mostly on granola bars and popcorn. It was a sad situation for several months before the family found out and hired a personal care agency to help prepare some hot nutritious meals. Preparing, cooking, and cleaning up all take energy and willpower and many seniors begin lacking both over time.

4.  Your aging parents are having a more difficult time getting around the house.

Joints get painful and muscles start atrophying with many seniors as they sit more and move less. Some begin to stumble and fall, which of course can be very dangerous. We always say, “One fall can change it all!” because we’ve seen it so many times. It’s best to remove any fall hazards in the home, especially loose rugs and items that block pathways. Look at getting a cane or walker to help stabilize your parents as they walk and be sure that all ice is cleared from walkways during the winter months.

5.  Your loved one is coming home from the hospital or rehab after a major fall or illness. Lonely-Senior-Developing-Dementia

The saddest scenario is when an elderly parent comes home after dealing with a hospital stay and they are too weak to get around on their own. Both the kitchen and bathrooms can be especially difficult to navigate while trying to recover. There are so many hard surfaces, slick floors, and sharp edges in a bathroom and kitchen, so one fall can easily result in bad bruises and/or broken bones.

Hiring a personal care agency can make all the difference.

Changes to seniors can be hard to notice, especially if you see them every day or so. Family coming in from out of town usually notice certain changes right away, whether it’s a change in cognition or memory loss or just the cleanliness of the home. Asking for extra help blesses your loved one and you. If you are the primary caregiver, it’s important to recognize if you’ve been feeling worn down and overworked as this is a good indication you may need more help as well.

A personal care agency can make all the difference during these sometimes difficult transitions. It’s always better to seek help before the crisis hits. Although that’s easier to say than do, we encourage families to get a little extra help going as soon as possible. Then, when a lot more help is needed, your aging parent will already feel comfortable having more assistance in their home.

Contributed by Gary Staples, Owner of Aspen Senior Care

 

 

Stop a Stroke: How Caregivers Can Spot a Stroke Risk

Senior Care Utah

Although a stroke is the fifth leading cause of death in the US, very few people understand how to recognize the signs and symptoms. Some risk factors such as such as age, race, and heredity can’t be changed. However, with the right knowledge, risk factors can be addressed and 80% of strokes can be prevented.

Types of stroke

A stroke occurs when the brain’s blood supply is severely reduced or completely stopped. This causes brain cells to become damaged or die due to lack of oxygen. Because the brain becomes severely damaged without oxygen, it is important to act quickly. A stroke can cause long-term damage, disability, and even death.  

Here are the different types of strokes:

Ischemic Stroke – This type of stroke occurs when a fatty plaque clot or mass clogs a blood vessel and stops blood flow to brain cells.

Hemorrhagic Stroke – This type of stroke occurs when a damaged or weakened vessel ruptures and bleeds out into the surrounding brain tissue. The blood gathers and forms a bruise which compresses the brain cells and causes them to die.

TIA (Transient Ischemic Attack) – A TIA is a medical emergency. It is referred to as a “mini stroke” and mimics the symptoms of a stroke. It is caused by a temporary clot and does not cause permanent damage to the brain. However, about 15% of all strokes happen after a TIA occurs.

Stroke Types 2018

 

How to spot a stroke

Symptoms of a stroke are reflected in the areas of the body controlled by the damaged brain cells. Remember to act F.A.S.T to reduce the damage caused by a stroke.

Courtesy of StrokeAssociation.org

Courtesy of StrokeAssociation.org

Learn to manage the risk factors

Although not all risk factors are preventable, there are many that can be addressed to minimize the possibility of experiencing a stroke. Along with monitoring your overall health, visit a physician to do a yearly health exam.

  • Manage high blood pressure – HBP is the leading cause of strokes and is highly controllable.
  • Control cholesterol
  • Eat a healthy diet
  • Be active and maintain a healthy weight
  • Manage diabetes and control blood sugar
  • Do not smoke

The Most Common Types of Infections in the Elderly (and How to Treat Them)

Photo courtesy of Pixabay(OpenClipart-Vectors)

Infections in the Elderly

Did you know that almost a third of all senior deaths are caused by an infectious disease? This is often due to the difficulty in discovering and diagnosing these illnesses, as the standard warning signs of infection materialize differently in a senior’s body. Furthermore, new strains of bacteria are continuously developing a stronger resistance to antibiotics, which doesn’t help the already aging immune system of your loved ones.

Because of these concerns, it is imperative for all caregivers to familiarize themselves with these common infections in the elderly and their warning signs, as well as what treatments are available. Here is a list of the most common infections you need to be aware of.

Urinary Tract Infections

A UTI is the most common form of infection found in seniors. Usually, this term is used to refer to a bladder or urethra contamination, but this bacteria can also spread to the kidneys which becomes a much more dangerous problem.

Senior’s who suffer from diabetes or use a catheter are at a higher risk, but other causes (such as an enlarged prostate, an increase in vaginal pH, or not emptying the bladder properly) are also widely reported.

The standard symptoms of urinary tract infections (such as pain, discomfort, fever, and persistent desire to urinate) are not always immediately evident in seniors. Rather look out for confusion or increased dementia symptoms, and if any vomiting occurs, seek immediate help.

The correct treatment depends on the infection itself, which is why a proper diagnosis is essential while ensuring the patient is properly hydrated.

Skin Infections

Photo courtesy of Pixabay(DarkoStojanovic)

Photo courtesy of Pixabay(DarkoStojanovic)

This is an umbrella term for a myriad of ailments such as shingles, pressure ulcers, fungal foot infections, or the Methicillin-resistant Staphylococcus aureus. Seniors are less able to fight off these infections as their aging skin does not heal as quickly as it used to. Diabetes also plays a negative role.

These skin conditions can come from an array of sources, including a weakened immune system, lack of mobility, moisture, or human contact (which includes communal showers).

Look out for any pain, itching, unfamiliar marks, or rashes. Mild fevers have also been reported. As always, the prevention of superficial infection is your best approach. Good hygiene is a must especially in a communal environment, so encourage hand washing and regular bathing schedules.

Vaccines and the proper disposal of all bodily secretions are also important considerations. If someone is already infected, isolate them from any other human contact and treat their contamination with antiviral agents.

Influenza and Pneumonia

An unattended respiratory infection (influenza) may develop into a severe lung inflammation (pneumonia) where the air sacs fill up with fluid and harden. This is the fifth leading cause of death for seniors due to diminished lung capacity, exhausted immune systems, or pre-existing conditions (such as cardiopulmonary disease or diabetes).

These germs are usually spread from person to person, transmitted via a cough or a sneeze, and then inhaled into the lungs. Community settings and closed environments are a definite reason for increased concern.

Be on the lookout for any obvious signs (such as the chills, coughs, sore throats, and fevers) but be aware that these symptoms are often less clear in seniors. Sudden headaches and a weakened demeanor are early red flags, while subtle changes in their behavior (including confusion and delirium) should also be watched carefully.

Routine checkups, pneumococcal vaccines, and a strict no-smoking policy are some of the best methods of prevention, while antibiotics from a doctor should be used to treat an existing condition. And remember that the sooner someone gets diagnosed, the better their chance of a swift recovery.

Photo courtesy of Pixabay(geralt)

Photo courtesy of Pixabay(geralt)

Gastrointestinal Infections

There are various types of bacterial infections which affect the stomach and/or the small intestine, but Helicobacter pylori and Clostridium difficile are the most common.

These outbreaks can be passed on from individual to individual or introduced to the system via means of undercooked food/contaminated water. The risk of infection is increased when traveling to foreign regions which contain viruses that their body is not accustomed to.

The standard symptoms of gastrointestinal infections can be expected here, and include abdominal pain, fever, nausea, vomiting, and diarrhea. This rapid loss of liquid means that you need to continuously hydrate the patient while making a quick diagnosis. If other people feel unwell who also consumed the same meals, then it is safe to assume that this is a food-related outbreak and you can take it from there.

Stomach troubles such as these usually clear up on their own within a few days. However, always speak to a medical professional just to be safe, and use this threat as a good incentive to thoroughly clean your hands before eating anything.

Contributed by Vive Health Writers

Preventing Pressure Sores in Seniors

Preventing Pressure Sores in Seniors

How to prevent pressure sores in seniors

A better understanding of what causes pressure sores helps caregivers take better care of their elderly loved ones. A pressure sore (also known as pressure ulcer and bedsore) is a result of tissue getting compressed between bone and an external surface. Pressure sores affect seniors who are unable to move and change position regularly. Prolonged pressure on the compressed areas leads to reduced blood supply (and eventual death) to the skin and underlying muscle tissues. Skin becomes dry and flaky and can break open which allows bacteria to enter the wound. 

Pressure sores/ulcers are located in areas such as the head and ears, elbows, shoulders, heels, and the sacral region and are graded or staged to classify the degree of tissue damage.

A body indicating the areas of the body where pressure sores may occur

Pressure sores are characterized by four stages dependent on the severity and depth of the lesion

Stage 1:    Pressure sores involve the superficial skin layer. The area has prolonged redness or “non-blanchable redness” (the area is red and does not go back to normal color when the senior is moved). The area can also turn pale or shiny and white.

Stage 2: Pressure sores involve superficial lesions to the top layer of skin. This results in a shallow depression or abrasion causing skin breakdown, blisters, shallow craters, edema, drainage, and possibly infection.

Stage 3: Pressure sores have full skin loss and extension into the subcutaneous tissue causing necrosis, drainage, and localized infection.

Stage 4: Pressure sores have damaged the muscle, fascia, and bone with deep infections, drainage, and death of the tissue (necrosis). Consequently, when a senior enters this stage they will always have a stage 4 ulcer. Although pressure sores may heal on the surface, the sores are deep and usually slow to heal. Due to this, pressure sores re-open easily.

Image showing the 4 stages of pressure sores

In most cases, seniors have special skin care needs because their skin becomes dry and thin as they age. If it becomes too dry, skin is prone to cracking and dermatitis. In addition, this allows for the growth of bacteria which can result in infection. Prevention of and assessment for pressure sores/ulcers and skin tears will avoid discomfort and decreased quality of life for seniors.

Prevent pressure ulcers and skin tears:

  • Relieve pressure by off-loading weight  
  • Prevent shearing and friction with careful transfers
  • Provide good personal care
  • Adequate nutrition and hydration
  • Loose, non-binding clothing

What can you do as a caregiver?

  • Reposition often: seniors need to be turned frequently to avoid pressure-sensitive ulcers.  
  • Check skin and all pressure points frequently
  • Give good skin care: powder which keeps areas clean and dry, lotion which keeps skin hydrated and elastic
  • Give good perineal care—toilet often and clean area well
  • Help the client exercise regularly – whatever the client is capable of doing
  • Make sure bed linens are clean, dry and wrinkle free
  • Give gentle massages to increase blood flow
  • Encourage fluids and good nutrition
  • Use pressure reducing devices: pillows, coccyx cushion, air mattress, barrier cream

What should you report to the doctor, Home Health nurse, or other healthcare providers?

  • Redness that won’t go away
  • Pale, white, shiny area over a bony prominence
  • Red, hot, tender to touch
  • Pressure ulcer that has increased in size or depth
  • Senior reports pain
Aspen Senior Care team photo

Aspen Senior Care has won Provider of Choice for 8 years in a row!

Aspen Senior Care trains our caregivers to follow these guidelines to ensure we provide our clients with the best possible care. We know how important it is to have caregivers our clients can trust. Because of this, we provide monthly in-service training to cover important educational topics. This improves the quality of life for both the caregiver and the senior receiving care.  Click here to learn more about our professional caregivers.

 

Information presented by Amanda Hensler

First Choice Home Health & Hospice

What is Frontotemporal Dementia?

What is Frontotemporal Dementia?

According to The Association for Frontotemporal Degeneration (AFTD), Frontotemporal Dementia (FTD) refers to a progressive disease process which causes a group of brain disorders. These disorders result in cell damage to specific areas of the brain – the frontal lobes and/or the temporal lobes.  The atrophy of these nerve cells interferes with brain activity and causes a loss of function in these regions of the brain.

Frontotemporal Dementia is different from other types of dementia in two important ways:

  • The trademark of FTD is a gradual, progressive decline in behavior and language with memory usually remaining intact. As FTD progresses it gets more difficult for the person to plan or organize activities, interact with others appropriately, and care for themselves.
  • In the majority of cases, FTD occurs earlier in life in people between the ages of 45 to 65, although it has been seen in people as young as 21 and as old as 80.

Frontotemporal Dementia is often misdiagnosed as a psychiatric problem or a movement disorder, such as Parkinson’s Disease. This is because certain symptoms of FTD mimic other diseases and in other cases, individuals are considered “too young” to have dementia.  According to AFTD, Alzheimer’s Disease is another possible misdiagnosis; however, the largest difference is that FTD affects language and behavior, while AD affects memory. 

Brain image of FTD vs Alz: image from medschool.ucsf.edu

Image from medschool.ucsf.edu

FTD makes up about 10%-20% of all dementia cases and the course of FTD ranges from 2 to over 20 years. The average length is about 8 years from the beginning of symptoms. It affects both men and women and, in some cases, can be inherited.

According to HealthLine.com, symptoms of FTD differ depending on the area of the brain affected, but most symptoms fall under behavior or language.

Common Frontotemporal Dementia behavioral issues include:

  • Loss of empathy
  • Inappropriate actions
  • Compulsive behavior
  • Lack of inhibition or restraint
  • Neglect of personal hygiene and care

Common Frontotemporal Dementia language-related symptoms include:

  • Difficulty speaking or understanding words
  • Problems recalling language
  • Loss of reading and writing skills
  • Difficulty with social interactions

Cognitive and Emotional symptoms of FTD include:

  • Difficulty planning, organizing, and/or executing activities
  • Becoming less involved in daily routines
  • Abrupt mood changes
  • Apathy
  • Emotional withdrawal
  • Becoming distracted
  • Reduced initiative

FTD Movement symptoms include:

  • A difference in gait, such as walking with a shuffle
  • Tremors
  • Muscle weakness, or cramps
  • Clumsiness
  • Apraxia (Loss of ability to make motions which are usually common and easy, such as using utensils)

Proper diagnosis is crucial because some medications used to treat other types of dementia may be harmful to a person with FTD. Unfortunately,  AFTD reports no cures at this time. However, research is ongoing and rapidly increasing, and new drugs are beginning to be clinically tested.  

Most importantly, remember that those dealing with any form of dementia are not doing these things on purpose. When providing care, caregivers sometimes trigger behaviors without realizing it. By understanding more about the many different types of dementia, caregivers can begin to improve quality and enjoyment of life at whatever stage of dementia a person happens to be in.

Visit The Association for FrontoTemporal Degeneration

AFTD helpline: 866-507-7222

Learn about different types of dementia in our other blog posts!

Understanding Dementia

Understanding Alzheimer’s Disease

What is Vascular Dementia?

What is Lewy Body Dementia?

______________________________________________________________________________________________________________________________________

Aspen Senior Care provides in-home care for seniors with all types of health challenges, including all forms of dementia.

Aspen Senior Day Center in Provo provides adult day care services (fun activities and personal care) for seniors with all types of dementia.

Contact Karen Rodgers, Family Caregiver Coach, for a free assessment to help you navigate the challenges of caregiving. You can reach her at 801-224-5910.

Visit aspenseniorcare.com or call our office at 801-224-5910 for more information.

Understanding Alzheimer’s Disease

What is it?

Alzheimer’s Disease is the most common form of dementia and makes up about 60% to 80% of dementia cases.  However, many researchers believe this number is too high and that other forms of dementia may be under diagnosed. On average, a person diagnosed with Alzheimer’s will live with the disease for 4-8 years depending on the person’s health and age.  The majority of cases are people aged 65 and older.

In some cases, individuals with this disease aren’t diagnosed until they have had the disease for a few years because the symptoms come on gradually and can be confused with normal aging.

A healthy brain versus a brain affected by Alzheimer’s Disease.

What causes Alzheimer’s Disease?

Although there are ongoing studies, Alzheimer’s Disease is believed to be caused by protein build-up in the brain. These abnormal protein particles are called tangles and plaques and as these tangles and plaques start to attach to nerve cells in the brain, they block communication between the cells and also keep the cells from getting nutrients and oxygen to survive. When a nerve cell dies, that part of the brain shrinks causing the disease to gradually worsen over time. Subsequently, this begins to affect memory, thinking, and behavior as the brain’s “file system” is progressively removed.

Symptoms include:

  • Forgetting how to use common, everyday items
  • Forgetting how to do common activities, such as cooking and driving
  • Misplacing things and not being able to problem solve to find them
  • Becoming fearful or jealous of people
  • Unable to find the right words to speak or write
  • Repeating the same question over and over
  • Poor judgment about appropriate behavior
  • Confusion about time and place
  • Mood and personality changes
We Are People Who Have Alzheimer’s. We Are Not Alzheimer’s.

We Are People Who Have Alzheimer’s. We Are Not Alzheimer’s.

According to the Alzheimer’s Association, there are different stages of the disease which will progressively worsen over time, although the disease will affect each individual differently. Initially, early-stage Alzheimer’s Disease will result in mild memory loss but as it progresses towards late-stage, the disease removes functionality and the ability to make conversation or respond to what is happening around one’s environment.  

Unfortunately, medication does not slow down the progression of Alzheimer’s Disease.  However, there are both drug and non-drug treatments which can help neurons in the brain to fire, aiding in cognitive and behavioral symptoms. 

 

To learn more about Alzheimer’s Disease and other Dementia related topics, visit our blog or the following websites:

Alzheimer’s Association  (24/7 Helpline: 1-800-272-3900 and Find Your Local Chapter)

NIH –  National Institute on Aging

Mayo Clinic

______________________________________________________________________________________________________________________________________

Learn about different types of dementia in our other blog posts!

Understanding Dementia

What is Vascular Dementia?

What is Lewy Body Dementia?

What is Frontotemporal Dementia?

______________________________________________________________________________________________________________________________________

At Aspen Senior Day Center in Provo, we provide adult day care services (fun activities and personal care) for seniors with all types of dementia.

Aspen Senior Care provides in-home care for seniors with all types of health challenges, including all forms of dementia.

Contact Karen Rodgers, Family Caregiver Coach, for a free assessment to help you navigate the challenges of caregiving. You can reach her at 801-224-5910.

Visit aspenseniorcare.com or call our office at 801-224-5910 for more information.

 

 

Preventing Elder and Vulnerable Adult Abuse

Lonely-Senior-Developing-Dementia

Preventing Elder and Vulnerable Adult Abuse

This month we had the opportunity to learn about Adult Protective Services and the prevention of abuse for vulnerable and elderly adults.  Debbie Booth from Adult Protective Services taught how we as professional caregivers can prevent abuse, neglect, and exploitation of the seniors in our care.   

Who is considered a Vulnerable Adult?

  • An elder adult, defined as anyone 65 years of age or older.
  • An adult 18 years of age or older who has a mental or physical impairment which substantially affects that person’s ability to:
    • Provide personal protection
    • Provide necessities such as food, shelter, clothing, or mental or other health care
    • Obtain services necessary for health, safety, or welfare
    • Carry out activities of daily living
    • Manage the adult’s resources
    • Comprehend the nature and consequences of remaining in a situation of abuse

What can Adult Protective Services do? 

  • Investigate reports of abuse, neglect, or exploitation
  • Perform needs assessments
  • Coordinate with and refer to community resources for services

What can Adult Protective Services not do?

  • Take custody of an adult.
    • Adults have the right of self-determination unless there is imminent danger of injury or death
  • Under APS authority, place an adult in a nursing home or other facility.
  • Provide any service without the voluntary consent of the alleged victim or their guardian/conservator unless court ordered to do so.

“…Caretakers are our eyes and ears in terms of protecting this very vulnerable population.”

– Debbie Booth

Debbie also taught our team how to spot and report abuse, neglect, and exploitation of vulnerable adults by being aware and watchful of the following signs:

ABUSE

  • Unexplained bruises or welts
  • Multiple bruises in various stages of healing
  • Unexplained fractures, abrasions, and lacerations
  • Multiple injuries
  • Low self-esteem or loss of self-determination
  • Withdrawn, passive, fearful
  • Reports or suspicions of sexual abuse

NEGLECT

  • Dehydration
  • Lack of glasses, dentures, or other aides if usually worn
  • Malnourishment
  • Inappropriate or soiled clothes
  • Over or under medicated
  • Deserted or abandoned
  • Unattended

SELF-NEGLECT

  • Over or under medicated
  • Social isolation
  • Malnourishment or dehydration
  • Unkempt appearance
  • Lack of glasses, dentures, or hearing aides, if needed
  • Failure to keep medical appointments

EXPLOITATION

  • Possessions disappear
  • Forced to sell house or change one’s will
  • Overcharged for home repairs
  • Inadequate living environment
  • Unable to afford social activities
  • Forced to sign over control of finances
  • No money for food or clothes

In the state of Utah, it is the law that any person who has reason to believe that a vulnerable adult is being abused, neglected, or exploited must immediately notify Adult Protective Services intake or the nearest law enforcement office.

 

To Report Elder and Vulnerable Adult Abuse, Please call:

Salt Lake: 801-538-3567

Statewide: 800-371-7897

Click here to learn more about APS
Visit our website at aspenseniorcare.com for more information regarding in-home senior care.

**All information was provided by Debbie Booth from the Division of Aging and Adult Services for the State of Utah Department of Human Services**

 

 

What a Caregiver Can Expect During the Final Act of Living

Caregiver

The topic of death and losing a loved one, for many, is a difficult topic to address and understand. Every individual will go through a different process and each caregiver will experience different emotions. There is no right or wrong way to feel when the one you love is reaching the final act of living.

“I truly believe it’s all about the living. We are born and we die and everything in between is living, clear until our last breath.” – Diana Cazier

For our in-service for the month of February, Aspen Senior Care had the wonderful opportunity to have Diana Cazier from Elevation Home Health and Hospice teach our team about the sensitive topic of recognizing the signs to look for when your loved one is in the final act of living. She referred to the booklet by Barbara Karnes, RN, titled, “The Final Act of Living: Reflections of a Long-Time Hospice Nurse”.  

The final act of living is a challenge.  This is a flexible guideline for what caregivers can watch for because no one knows the exact date that someone will pass.

Signs to look for in the Final Act of Living

One to three months before death:

  • Withdrawal from world and people
  • Decreased food intake
  • Increase in sleep
  • Going inside self
  • Less communication

One to two weeks before death:

Mental Changes

  • Disorientation
  • Agitation
  • Talking with the unseen
  • Confusion
  • Picking at clothes

Physical Changes

  • Decreased blood pressure
  • Pulse increase or decrease
  • Skin color changes; pale, bluish
  • Increased perspiration
  • Respiration irregularities
  • Congestion
  • Sleeping but responding
  • Complaints of body tired and heavy
  • Not eating, taking little fluids
  • Body temperature: hot, cold

 

 

Days or hours before death:

  • Intensification of one to two week’s signs
  • Surge of energy
  • Decrease in blood pressure
  • Eyes glassy, tearing, half open
  • Irregular breathing: stop, start
  • Restlessness or no activity
  • Purplish, blotchy knees, feet, hands
  • Pulse weak and hard to find
  • Decreased urine outlet
  • May wet or stool the bed
  • Acetone breath

Minutes before death:

  • “Fish out of water” breathing
  • Cannot be awakened

Through this presentation, we were taught how to be more aware and understanding of the different signs we may observe as one approaches death from disease or old age. We are so grateful to Diana for her presentation as it will continue to help us be more supportive and observant as professional in-home caregivers.

“At Aspen Senior Care, we like to align ourselves with the finest Home Health and Hospice agencies in Utah. We appreciate their willingness to present at our in-service training and reach us about important topics.  We are better because of it.”

Gary Staples, Owner and Administrator

 

If you have any questions, or if you need further support, contact us today at 801-224-5910. You can also refer to “The Final Act of Living: Reflections of a Long-Time Hospice Nurse” by Barbara Karnes, RN.

For more information and topics about in-home care, visit aspenseniorcare.com