‘When Breath Becomes Air’ Review

One of the mysteries of life can be falling in love. A song by Julia Fordham brings this point home with the following lyric: “Love moves in mysterious ways. It’s always so surprising when love appears over the horizon.” You don’t know who you will fall in love with, where it will happen or when it will happen. For Lucy Kalanithi and John Duberstein, fate or a higher power might have had a hand in their falling in love. Lucy is the spouse of Paul Kalanithi, who wrote “When Breath Becomes Air,” a memoir about his unique end-of-life journey from a physician’s perspective. John Duberstein’s wife, Nina Riggs, penned “The Bright Hour,” which chronicles her thoughts about living and dying. Last month in the Washington Post, a story shared the news that Lucy and John found each other and fell in love after losing their spouses, both best-selling memoirists.

The Infancy of When Breath Becomes Air

Medicine was not on Dr. Paul Kalanithi’s professional horizon when he went off to college at Stanford University. He wasn’t going to go into the family business of medicine—his father, uncle and older brother were all physicians. In fact, the first sentence of Part I, “In Perfect Health I Begin,” he states: “I knew with certainty that I would never be a doctor.”

Yet Paul was always fascinated by the connection between literature and science. “Literature provided a rich account of human meaning; the brain, then, was the machinery that somehow enabled it.” Graduating with degrees in English literature and human biology, Paul decided to pursue a master’s degree and center his thesis around the same questions Walt Whitman constantly pondered─understanding “the Physiological-Spiritual Man.”

Upon the completion of his thesis, which was more science than literary criticism, Paul realized that medicine was his calling after all. Becoming a physician would allow him “to forge relationships with the suffering, and to keep following the questions of what makes human life meaningful, even in the face of death and decay.”

Road to Neurosurgery

After completing medical school at Yale University, it was time for Paul to choose a specialty for his residency match. With his ongoing fascination of the mind and how it works, neurosurgery was the perfect fit.

Becoming a neurosurgeon is a long and arduous road; but ultimately for Paul, it was worth it. He believed, “While all doctors treat diseases, neurosurgeons work in the crucible of identity: Every operation on the brain is, by necessity, a manipulation of the substance of ourselves, and every conversation with a patient undergoing brain surgery cannot help but confront this fact.”

The end was almost in sight for Paul. He was down the home stretch as chief resident when he was given the worst news possible: a diagnosis of stage IV lung cancer. With one short inhalation and accompanying exhalation, his dream, career and the life he planned with his wife evaporated.

What was hard for Paul was the fact that his identity as a physician no longer mattered. With his diagnosis, he would walk in a patient’s shoes. Paul did win his battle with the diagnosis for some time, to the point, where he returned to complete his residency. Additionally, Lucy and Paul had a daughter, Cady, who arrived on Independence Day in 2014.

Paul was determined to leave a legacy of his words for his daughter. During the last year of his life, he diligently wrote “When Breath Becomes Air.” From his standpoint, words have a longevity that he did not. Paul had one message for his daughter: “…do nor, I pray, discount that you filled a dying man’s days with sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied.”

In the epilogue for “When Breath Becomes Air,” Lucy states that Paul died on Monday, March 9, 2015, surrounded by his family. As both a physician and patient, Paul confronted death—“examined it, wrestled with it, accepted it.” With this memoir, Lucy believes her husband wanted to help people understand death and face their own mortality. Although his time on earth was short, Paul did manage to live a meaningful life.

Stay tuned for a blog post in two weeks, when we take a closer look at Nina Riggs’ memoir, “The Bright Hour,” about her end-of-life journey.

At Chapters Health System and its affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Stories of Love

Although love can be in the air any day and at any time, there is a sense of heightened awareness around Valentine’s Day. Stories of love can come in all different shapes and forms: movies, books and songs. The following are some of our favorites even if the ending isn’t necessarily happily ever after.

Movies

Casablanca (1942)
Love Story (1970)
The Way We Were (1973)
An Officer and a Gentleman (1982)
When Harry Met Sally (1989)
Ghost (1990)
Titanic (1997)
Love Actually (2003)
Silver Linings Playbook (2012)
La La Land (2016)

Books

Gone with the Wind by Margaret Mitchell
Time Traveler’s Wife by Audrey Niffenegger
Me Before You by Jojo Moyes
Wuthering Heights by Emily Brontë
Jane Eyre by Charlotte Brontë
Outlander by Diana Gabaldon
The Night Circus by Erin Morgenstern
The Notebook by Nicholas Sparks
Hotel on the Corner of Bitter and Sweet by Jamie Ford
The Bridges of Madison County by Robert James Waller

Songs

At Last by Etta James
It Had to Be You by Harry Connick Jr.
I Will Always Love You by Whitney Houston
When a Man Loves a Woman by Percy Sledge
The First Time I Ever Saw Your Face by Roberta Flack
All of Me by John Legend
Time After Time by Cyndi Lauper
You Are So Beautiful by Joe Cocker
I Want to Know What Love Is by Foreigner
Endless Love by Lionel Richie and Diana Ross

We would love to find out your favorite love stories, movies and songs. Please share in the comments.

Hospice Volunteer: A New Way to Getting Involved

Benjamin Franklin knew a thing or two about the certainty of life, but he never visited LifePath Hospice’s Melech Hospice House in Temple Terrace, Florida. If he had, this Founding Father of our nation would have added a third sure thing to his list: Every Wednesday, Ben Franklin would be welcomed and greeted by hospice volunteer Beth Glenn and her loyal sidekick Fuzzy Rogers.

Q and A with a Hospice Volunteer

We sat down with Beth and asked her about how she and Fuzzy came to LifePath Hospice and how it changed their lives.

Question: What made you decide to volunteer?

Answer: After I retired from teaching elementary school for 30 years—third and fifth grade math and science in Hillsborough County, I was looking for something to do with my time. I had specific criteria. I wanted to do something new, and the activity needed to involve dogs. I’ve always loved dogs: I grew up with Dalmatians. In addition, wherever I volunteered, the mission needed to be attainable for the organization. The first organization I volunteered with was Southeastern Guide Dogs headquartered in Bradenton.

After volunteering there for some time, I became involved with the organization’s ambassador program. I started going out into the community attending events with my first ambassador dog, Dipaolo, which included visits to assisted living facilities in Plant City. These activities led me to hospice and specifically to LifePath Hospice and the Melech Hospice House. Once again, my criteria were met with regard to volunteering with my dog and the mission of the organization being attainable. Dipaolo was the first dog that I volunteered with for LifePath Hospice.

Question: How long have you volunteered?

Answer: It has been a couple of years since I became a hospice volunteer. I have always been at the Melech Hospice House. A couple of months ago, Dipaolo retired as a Southeastern Guide Dog ambassador and Fuzzy Rogers, my black lab, filled his paws. Any visitor coming into the house on a Wednesday from about 10:30 a.m. to 1:30 p.m. knows Fuzzy Rogers. He is by my side at the front hospice volunteer desk as people sign in.

Question: Tell us more about Fuzzy Rogers. How did he become involved in pet therapy?

Answer: Fuzzy Rogers actually has a couple of names—Fuzzy, Fuzz Ball, Fuzzy RaRa, Mr. Rogers and The Fuzz. I did not name him. It is the practice of Southeastern Guide Dogs to have fundraisers to name its puppies. Also, I did not train him as a puppy. Fuzzy was trained by a Texan who I will get to meet face to face later this month.

Fuzzy Rogers is a very friendly dog, which does not make him a good guide dog. He is also reserved, which makes him better suited for pet therapy. He is excellent at greeting visitors and enjoys guiding family members and friends to where they need to go in the building. There are many times when Fuzzy and I are requested to visit a specific patient’s room. Our presence is truly to benefit the family more so than the patient in most instances. Petting a dog is therapeutic and helps to relieve stress.

Question: What do you enjoy about volunteering?

Answer: Fuzzy and I get to interact with all different people who walk through the front doors of Melech Hospice House. We talk and learn from one another, and petting Fuzzy gives them the prompt to comfortably share their feelings. As hospice volunteers, Fuzzy and I are given the opportunity to change lives at a very stressful time for them.

Question: Can you share any stories about the impact that Fuzzy Rogers has had on patients and families?

Answer: A young man with autism had been visiting with his grandmother, and she shortly thereafter passed away. He was pacing back and forth trying to return to the room and was visibly distraught. The family was doing their best to settle him down, and it just wasn’t working. The young man’s mother told me that he is nonverbal. He avoids eye contact and touch at all costs.

Fuzzy sensed that this young man was upset, so he sat in front of him waiting patiently. The young man stopped pacing, looked at Fuzzy and kneeled down snuggling and kissing Fuzzy on the forehead. They looked into each other’s eyes as if they were connecting on a higher level. When they left, the young man smiled and waved goodbye. His family told me this was extremely out of character for him. In fact, they have a dog at home that the young man totally ignores.

Fuzzy helped the young man calm down, and the family was able to go home and grieve their loss together. The mother thanked us for the interaction and said she will always remember that moment. She was very appreciative at the difference we made with the loss of her mother.

Question: What would you say to someone who is thinking about becoming a hospice volunteer?

Answer: I had a hospice experience in my own family in the late 1980s and already knew how comforting the care can be for patients and loved ones. But being a hospice volunteer, I realized something very important: It is not depressing to volunteer for hospice. It is actually uplifting and positive. Hospice is not sad, and it is okay to laugh and smile. It definitely helps when you have a sidekick like Fuzzy.

At Chapters Health System, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Top 5 Characteristics of a Great Hospice Volunteer

At Chapters Health, we believe there is no volunteer opportunity more rewarding than helping at one of our hospices. There are many ways to volunteer with Chapters Health and our affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice: Patient and family support, grief support and other roles such as making phone calls to patients, copying, filing and helping with mailings.

Anyone can volunteer, but it takes a special person to be a hospice volunteer. These top five characteristics define what it takes to be a great hospice volunteer.

Patience

With terminal diagnoses, no two patients will follow the same end-of-life process. A great volunteer accepts this fact and possesses the patience to assist patients and families through the journey. If volunteering for any of the children’s grief camps, the person should be patient as well easy-going when working with kids.

Compassionate

Make no mistake about it: Volunteering with hospice can be filled with challenges. No matter how volunteers spend their time, they help to make sure patients’ remaining days, as well as the lives of their families, are filled with the warm touch and special attention they deserve.

A hospice volunteer is often presented with the opportunity to display compassion and understanding. A great hospice volunteer welcomes these opportunities and is empathetic. Caring about others is one of the most defining characteristics an individual can possess if interested in volunteering for hospice.

Flexible

As a seasoned hospice volunteer will tell anyone contemplating the opportunity, there’s one thing that’s guaranteed: Things will not always go the way you think they should. Things change quickly in hospice for a wide variety of reasons. Therefore, it is important that if you want to be a hospice volunteer, you are open to change.

Communicator

In the Journal of Aging and Identity, while describing communication in hospice volunteer-patient relationships, Elissa Foster emphasized a focus on the patient as living rather than dying. Hospice volunteers learn that contrary to assumed expectations, very little of their experience with patients is centered on death. Faced with end-of-life care, an ability to shift focus to living rather than dying suggests an advanced level of consciousness. A great hospice volunteer recognizes the importance of open, honest communication and possessed the ability to talk with others.

Humble

While they may have a lot to offer, a great hospice volunteer recognizes that he or she also has much to learn. From patient and family support to grief support and a multitude of other opportunities, valuable insight can be gained from other hospice volunteers.

If you have these characteristics, please consider becoming a volunteer for Chapters Health or any of our affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice. It’s as easy as filling out an application, just click here. Or visit our opportunities page for more information. We’d love to have you, and as you learned from Beth and Fuzzy, volunteering can be quite rewarding!

‘Option B’ Review

‘Option B’ Review: How to Face Adversity

Sheryl Sandberg and Dave Goldberg had it all—great jobs (chief operating officer at Facebook and chief operating officer at Survey Monkey, respectively), two beautiful children and finally time together for an adult vacation in sunny Mexico with dear friends. That is until disaster struck. Sheryl was suddenly a widow and faced with the discovery that the long life she pictured with her husband was not to be. Her plan morphed from Option A into “Option B” in the blink of an eye.

Moving Toward Option B

Sheryl never dreamed her life would take such a detour—the future would be devoid of Dave. She constantly worried about the effects their father’s death would have on her two small children. It was a shock to everyone—family, friends and co-workers. Erasing the image of her son and daughter falling to the ground unable to move at the funeral was an impossible task for the Facebook executive.

In those early days and even the weeks and months to come, Sheryl felt as though her grief was always present. Then when milestones took place—the first day of school, a birthday party—she literally would be overcome with her devastating loss all over again, front and center. It was difficult for Sheryl to function. As a way of working through her all-encompassing emotions with the unexpected death of her beloved husband, Sheryl penned “Option B” along with the assistance of her friend, psychologist Adam Grant.

Facing Adversity

Over the course of one’s life, many people face hardships. There are events you can anticipate and prepare for, and others will catch you totally off guard. The unknown is scary, and a quote by C.S. Lewis brings this point home: “No one ever told me that grief felt so like fear.”

For Sheryl, her greatest fear was her children would never be happy again. People constantly told her things would get better and children are much more resilient than she thought. Nevertheless, Sheryl still found it a difficult concept to wrap her mind around. Early in “Option B,” she shared the following, which sheds light on why: “Just as the body has a physiological immune system, the brain has a psychological immune system. When something goes wrong, we instinctively marshal defense mechanisms. We see silver linings in clouds.”

After Dave’s death, Sheryl suffered because she was grief-stricken that she was grief-stricken. She was given a valuable piece of advice that helped her through the rough spots. Rabbi Nathaniel Ezray told her to “lean in to the suck”— she needed to expect life to be awful at times. Instead of being surprised by her negative feelings, Sheryl learned to expect them.

In Sheryl’s situation, death was the adversity she faced. For others, adversity can be a different type of loss: financial, divorce, illness and unemployment. Unfortunately, no one is immune.

Building Resilience

In 1972, Abraham Tesser and Sidney Rossen coined the term “mum effect” to describe how humans tend to avoid upsetting topics. After the death of a loved one, people are often afraid of talking about the loss with the person left behind—spouse, child or sibling. We naturally avoid the topic, not because we don’t care but because we fear it will be upsetting. Sheryl described this situation as the elephant in the room. “Even people who have endured the worst suffering often want to talk about it.”

Family, friends and coworkers want to help, but they just don’t know how or where to begin. Sheryl tackled it head on and exposed all her of her emotions in a very personal Facebook post about how she felt. The floodgates opened with an outpouring of comments and messages. The elephant was no longer in the room.

On the flip side, finding people—a kindred spirit if you will—can help build one’s resilience. Sheryl was fortunate to have the support system and resources needed to get them through the trauma. They asked for help. But unfortunately, in today’s society, many suffer in silence. Life does not have to be lived in isolation, alone and silent. There are resources available to help community members face adversity (see information in the sidebar of those available from Chapters Health System).

Finding Joy

In “Man’s Search for Meaning,” Viktor Frankel stated what helped him survive the Holocaust: “When we are no longer able to change a situation, we are challenged to change ourselves.” Many people who live through trauma and adversity become victims of post-traumatic stress disorder and experience many negative symptoms. However, Tedeschi and Calhoun discovered something totally different can occur: post-traumatic growth. Positive growth can take place in five categories:

Finding personal strength
Gaining appreciation
Forming deeper relationships
Discovering more meaning in life
Seeing new possibilities

For the sake of her family, Sheryl took this approach, Option B, to life without her husband. In the past, Dave, Sheryl and the kids would share their best and worst moments of the day during dinner. The re-tooled family of three adapted this old family tradition, and now share something that makes them grateful.

Taking the philosophy of Søren Kierkegaard to heart, in that life must be lived forward, Sheryl also would write down daily three things she did well and three moments of joy. It was the small wins that propelled and led her to realize that she could find joy again.

Even though life’s Option A is null and void, it shouldn’t prevent anyone from moving toward Option B, C, D, E, as the case might be. Just know that you are not alone.

Note: Sheryl is donating all of her income from “Option B” to OptionB.org, a non-profit initiative to help people build resilience and find meaning in the face of adversity.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Grief Support: Always Available

After the loss of a loved one, some survivors may find the pain associated with their loss doesn’t lessen with time. Individual grief counseling and support groups provide a safe place to express feelings, share experiences, learn about grief and move ahead in the process.

Chapters Health System and its affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice—offer various support groups and individual counseling. Our hope is that community members will take advantage of the programs that best suit their particular needs and circumstances. You don’t need to be the loved one of a patient at any of our hospices to participate in these support services.

We are pleased to offer our programs to anyone (adults and children) residing in Citrus, Hardee, Hernando, Highlands, Hillsborough, Pasco and Polk counties, who has experienced the death of a loved one. Preregistration is required for all offerings. For more information and to register for support groups, please call the Bereavement Department that’s most convenient for you.

In Polk, Highlands and Hardee counties, Good Shepherd Hospice Bereavement is 863.968.1707 or toll-free 1.800.464.3994.

In Pasco, Hernando and Citrus counties, HPH Hospice is 727.863.7971 or toll-free 1.800.486.9794.

In Hillsborough County, LifePath Hospice Bereavement is 813.877.2200 or toll-free 1.800.209.2200.

Raising Heart Disease Awareness (DRops of Wisdom)

Today we continue “DRops of Wisdom,” our physician blog, with Dr. Chad Farmer, medical director for LifePath Hospice. He describes the importance of raising heart disease awareness in women and men in anticipation of Heart Month.

Heart Disease and Valentines in February

The inaugural American Heart Month took place in 1964 thanks to a proclamation by President Lyndon B. Johnson. By joint resolution, Congress ensured that in future years, every President of the United States would officially announce February as Heart Month.

What happens exactly during Heart Month? It is time devoted annually to raise awareness of heart disease, the number one killer of women and men in the United States. Every year, the American Heart Association, in conjunction with the Centers for Disease Control and Prevention and National Institutes of Health, reports on current heart disease statistics across the country. Their findings are quite staggering.

In the United States alone, more than 92 million adults are living with some form of heart disease or after-effects of a stroke.
One in every three deaths in the United States is from heart disease. This means more lives are lost due to heart disease than all forms of cancer and chronic respiratory disease combined.
Every day, about 2,200 people die from heart disease. This is an average of one death every 40 seconds.

The population that is affected dramatically: women. While both women and men can experience typical heart attack symptoms, such as chest pains and breaking out in a cold sweat, many women also describe symptoms that aren’t thought of when talking about a heart attack. They can have nausea, shortness of breath and/or pain or discomfort in their stomach, shoulders, jaw, neck or back. Unfortunately, women shrug off the warning signs and attribute these symptoms to something else entirely.

The following are statistics for women and heart disease.

After experiencing their first heart attack, women age 45 and younger are more likely than men to die within a year.
If a woman thought she was experiencing any heart attack signs, only 65 percent would dial 9-1-1.

During the last 15 years, education for women about heart disease risk has increased due to the Go Red Movement and National Wear Red Day, which takes place this year on Friday, February 2. However, even more needs to be done, particularly when it comes to prevention.

The American Heart Association has an initiative in place called “Life’s Simple 7®,” which looks at seven measures designed to improve the heart health of people living in the United States. The goal is to get more Americans heart healthy by reducing death from heart disease and stroke by 20 percent in two years. The 2020 Impact Goal tracks the following: control of cholesterol, blood pressure and blood sugar, not-smoking, physical activity, healthy diet and body weight.

At Risk for Congestive Heart Failure

At Chapters Health System and its affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice, we have seen a steady increase in patients with chronic congestive heart failure (CHF). It is a type of heart disease that cannot be cured. The pumping action of the heart is inadequate, causing blood to back up into the lungs. This makes it difficult to breathe (left-sided heart failure). Blood also backs up into the veins, causing swollen legs and feet (right-sided heart failure).

According to Emory Healthcare, nearly 5 million Americans are currently living with this form of heart disease, and approximately half a million new diagnoses are made every year. CHF is the primary diagnosis in 875,000 hospitalizations and most common in patients who are 65 years or older.

For CHF, the Cleveland Clinic reports this type of heart disease occurs in men and women equally, and the prevalence is higher in African-Americans, Hispanics and American Indians than in Caucasians. And the America Heart Association claims that 53,000 Americans die from CHF every year.

How Chapters Health System Can Help

At Chapters Health System, we recognize the unique needs of patients with heart disease such as CHF. Our At Home with CHF program was specifically developed to meet those needs and help patients decrease unwanted hospitalizations.

Our At Home with CHF program includes the following for patients diagnosed with CHF:

Initial and ongoing education is provided to patients and families to assist in controlling the symptoms of CHF. Patients can therefore remain more comfortable wherever they call home.
Patients receive a form and scale to record their weight. In addition, check-in calls are made to find out if patients have gained weight or had any change in symptoms.
Patients also receive a color-coded tool that helps them “grade” their symptoms so they know when to call Good Shepherd Hospice, HPH Hospiceand LifePath Hospice for help.
Patients have 24/7/365 access to the HospiceHelp24® nursing hotline for immediate assistance with any change in their CHF symptoms, such as difficulty performing daily activities; increased shortness of breath; tightness in the chest; swelling of the feet, ankles or abdomen; and a rapid weight gain in one day of 3 pounds.

In addition, our hospice nurses are equipped to anticipate the needs and symptoms of CHF patients.

What Would You Like to Read About in Future Posts?

In “DRops of Wisdom,” we want to feature posts with subject matter that interests you. Please leave a comment or email us with your ideas.

About Dr. Chad Farmer

Dr. Chad Farmer, Medical Director for LifePath Hospice, is a local resource for area hospitals seeking to educate staff on issues surrounding chronic conditions, palliative care and hospice programs.

5 Tips to Decrease CHF Symptoms

If you or someone close to you suffers with CHF, the following is a list of things you can do to relieve the distress of symptoms.

Position yourself so you lungs will expand. Symptoms will decrease if you sit up in a chair or bed and lean slightly forward. Another tip is to rest your arms on pillows, the arms of a chair or an over-bed table. Additionally, it is important to keep your head elevated by raising the head of the bed or using several pillows.

Avoid things that increase shortness of breath. There are certain things that can trigger shortness of breath so it is important to avoid or keep them to a minimum. They are smoking, pollen, humidity and extremes in temperature (hot or cold).

Utilize prescribed medication and oxygen. If medication is prescribed and oxygen ordered, use as directed.

Reduce anxiety. If an activity can distract you from thinking about the feeling of shortness of breath, your anxiety can decrease. Some suggestions are watching television, and listening to music.

Increase air flow. It is important to get air circulating around you. Try turning on a fan and positioning so it is blowing on your face. Others tips are reducing the temperature in the room and applying a cool cloth to your face, neck or chest.

Try pursed-lip breathing. This tip helps by making breathing more effective for people with CHF. By keeping your lips together as if you are whistling, you then need to breathe through your nose and out slowly through your mouth.

Prevent infection. For individuals with CHF, it is important to prevent infections. This can be accomplished by washing hands frequently, avoiding people with upper respiratory infections and drinking plenty of fluids.

Pace yourself. In order to keep symptoms at bay, it is sound practice to avoid activities that increase shortness of breath, such as climbing stairs. Don’t overly exert yourself and rest between activities. Try positioning chairs throughout your home so that if you should need to rest you can. And if you need help, simply ask family and friends for assistance.

Compassion Fatigue: What Caregivers Need to Know

Family members who make sure their loved ones’ needs are met give the gift of caring every day. Caregivers shop for groceries, prepare meals, pick up prescriptions, assist with bathing and grooming—you name it, they do it. Caregivers make it their mission to do everything they can to make a loved one more comfortable at the end of life. Unfortunately, caregivers often times burn the candle at both ends and develop compassion fatigue.

What is Compassion Fatigue?

Compassion fatigue occurs when caregivers become stressed from caring for others. According to San Francisco psychotherapist Dennis Portnoy, “Compassion fatigue is caused by empathy. It is the natural consequence of stress resulting from caring for and helping…suffering people.”

Compassion fatigue can be thought of as extreme burnout. It doesn’t just happen overnight. As days, weeks and months (in some cases years) march on with mounting responsibilities, caregivers become overwhelmed physically, emotionally, spiritually and socially. Patricia Smith, founder of the Compassion Fatigue Awareness Project, said: “Every day in our caregiving role, we empty out in order to be present to those in our care. If we continue to empty out without filling up again, we place ourselves in harm’s way.”

So when it comes to this stress disorder, what should caregivers and their extended family be on the lookout for? The key indicator of compassion fatigue is sleep disruption. Caregivers with compassion fatigue often do not have the energy to deal with the issues that can materialize when caring for a loved one with a terminal illness. As a result, both the patient and caregiver suffer.

The following are some additional signs and symptoms associated with compassion fatigue:

Irritability
Decreasing ability to function
Pulling back from normal activities
Cancelling plans
Increasing aches and pains
Feeling bored and apathetic
Fatigue
Memory problems
Depression

Is it Possible to Combat?

The first step in combatting compassion fatigue is to recognize and be aware that it is present. If you are a caregiver and the above signs and symptoms ring true in your life, seek professional help and let others know.

However, in practical terms, what should a caregiver do as a quick solution? First and foremost, experts believe the solution is to stop caregiving, even if it is just for a day. The following are some suggestions on how to make this happen.

Start with a half-day off. If a full-day off from caregiving isn’t possible, start with a half day. But it shouldn’t be a one-and-done happening. Caregivers should try to schedule half-days off on a regular basis to avoid compassion fatigue.

Phone a family member or friend. Ask for assistance from another family member who can pitch in and help care for your loved one for the day. Even better would be to set up a rotating schedule for help.

Tap into available community resources. If caring for a loved one under hospice care, all affiliates of Chapters Health System—Good Shepherd Hospice, HPH Hospice and LifePath Hospice—have volunteers available to fill in and help.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

4 Tips for Caregivers

Although compassion fatigue is possible, caregivers can set themselves up for success with a proactive approach. The following are tips to avoid compassion fatigue.

Regain balance. Caregivers often run into a problem by setting unrealistic goals. Then there is also the distinct possibility that too much is expected of them. Caregivers often have countless tasks given to them by many people. To get back on track, set limits and be prepared to follow through when they are crossed.

Take time for yourself. A quote by Parker Palmer says it all: “Self-care is never a selfish act—it is simply good stewardship of the only gift I have, the gift I was put on earth to offer others. Anytime we can listen to true self and give the care it requires, we do it not only for ourselves but for the many others whose lives we touch.”

When things go wrong or when caregivers feel they can’t do one more thing, it isn’t a sign of failure or weakness. They just need stop and take care of themselves. It is not being selfish to take some time for yourself. Caregivers cannot help others if they are not balanced.

Express yourself. Like Madonna sang in the late 1980s, it is important to “express yourself.” Caregivers can avoid compassion fatigue by being mindful of their feelings inside and out. Feelings can be expressed verbally by talking with someone, or journaling can be beneficial when writing about the entire experience.

Take a deep cleansing breath or two. Deep breathing exercises can help decrease stress and allow time for caregivers to regroup. Don’t know where to begin? There are quite a number of smartphone apps, such as Calm, that can help with deep breathing, and iWatch users have Breathe at the touch of a button on their watch. So stop and take a breath.

For some additional caregiver tips, check out “Caring for the Caregiver.”

Using Food to Boost Brain Health: Is It Possible?

At some point in our lives, we have all heard the phrase “brain food” thrown around in conversation. But have you ever stopped to wonder if there was any truth behind it? Is there actually food you can eat to boost brain health? With the ever-growing rise in the number of people developing and facing memory loss and dementia, the answer to this question becomes increasingly important.

Foods Boosting Brain Health

There is definitely some merit to the phrase “You are what you eat,” coined in theory by Anthelme Brillat-Savarin and Ludwig Andreas Feuerbach. Food definitely has a bearing on the state of our health and well-being. It certainly isn’t a hopeless old wives’ tale to start and keep a well-balanced diet.

If we want to improve brain health, what food items need to become a staple in our refrigerator and pantry? Here are five foods that can help increase brain health.

Fish. Our bodies cannot make the essential fatty acids (EFAs) that are needed to keep our organs functioning, bones strong and much more. This means we need to find a food source to make sure that we receive this vital source of fat. One of the best and most effective sources is oily fish, such as salmon, sardines, trout and herring. If you are not a fish fan, have allergies or practice a vegetarian lifestyle, don’t worry. Essential fatty acids, like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), can be found in plant sources: Pumpkin seeds, walnuts and flaxseed. A study at the University of Iowa College of Public Health discovered a link between low levels of DHA and an increased risk of dementia. Therefore, we can assume that consuming fish and plant sources with high levels of EFAs can improve our brain health.

Eggs. This food group is known to have high levels of certain B vitamins, like B6, B12 and folic acid. These B vitamins they help to lower homocysteine (an amino acid) levels in our blood. When homocysteine is high, there’s an increased risk of not only having a stroke but also developing dementia. A research group at the University of Oxford put this concept to the test in a study. The results showed that after two years of having high levels of B6, B12 and folic acid, study participants experienced a lower rate of brain shrinkage versus those who were given a placebo.

Broccoli. This vegetable has high levels of vitamin K, which is known to improve brain health. Broccoli also is chock full of glucosinolate, which helps our nervous system work properly. Glucsosinolate assists in keeping a neurotransmitter, acetylcholine, in our system so our memory doesn’t deteriorate. Studies have shown that Alzheimer’s patients have low levels of acetylcholine.

Sage. A familiar song from the past for many, Simon and Garfunkel made a quartet of herbs popular, “Parsley, Sage, Rosemary and Thyme.” Little did they know that sage (and actually rosemary, too) is believed to improve memory and concentration. For the most part, studies on the effect of sage looked at its usage in the form of an essential oil—from an aroma perspective. Even though it hasn’t been put to the test, there’s nothing wrong with adding sage to a recipe to tap into its benefit of increasing brain health.

Nuts. This food item improves brain health as it increases a person’s intake of vitamin E. What’s so special about vitamin E? With results published in Nutrients, research uncovered that a steady dose of vitamin E could prevent a decline in memory. Therefore, brain health could be sustained with a diet of nuts, as well as other sources of vitamin E, like olives, leafy green vegetables and brown rice.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Latest in Brain Health Statistics

From social to financial to health, there are many challenges that we face today as life expectancy continues its march toward 100. One of the biggest that can be found is the exponential growth of patients and families battling with memory loss and dementia.

According to the Alzheimer’s Association, the following are some startling statistics when it comes to memory loss diseases:

More than 5 million Americans live with Alzheimer’s disease.
One in three seniors dies with Alzheimer’s disease or dementia.
Alzheimer’s disease is the sixth leading cause of death in the United States.
Every 66 seconds, someone in the United States develops Alzheimer’s disease.
By 2050, the number of people with Alzheimer’s disease in the United States could be as high as 16 million.
Since 2000, the number of deaths from heart disease decreased by 14 percent, while deaths from Alzheimer’s disease increased by 89 percent.

5 Early Warning Signs and Symptoms

As the current statistics show, it is more important than ever to be alert and knowledgeable about the early warning signs and symptoms of dementia and Alzheimer’s disease. If you were asked what to be on the lookout for, would you know? In case the answer is no, don’t worry as the following signs and symptoms are what you need to know:

Loss of memory that hampers daily life. Typically as we age, we tend to forget names or the fact that we scheduled a dentist appointment. However, when you start to forget recent information, which then needs to be repeated over and over again, this can be an early wanting sign.
Trouble solving problems or issues planning. For some, following a recipe that used to be a breeze becomes an impossible task. Concentrating on familiar tasks can prove difficult, which results in them taking much longer to complete than in the past. Additionally, working with numbers can become quite the challenge.
Forgetting dates, time and place. If someone is starting to show the early signs of dementia or Alzheimer’s, he or she can lose track of dates and time passing by. Individuals with memory loss issue can also forget where they are and even how they arrived there.
New trouble finding words when speaking or writing. If you know someone who has problems either joining or following a conversation, it isn’t something that should be dismissed. As we get older, it is normal to have trouble finding the right word; but with someone with memory loss or Alzheimer’s, they might use the wrong word entirely, for example, calling a dog a turtle.
Losing items with the inability to retrace your steps. Have you ever misplaced your wallet? But then you were able to think back, walk step-by-step, and find it in the center console of your car. This scenario can occur as we get older. Yet, if you lost your pocketbook and are unable to retrace your steps to find your favorite purse, this can be an early sign of dementia or memory loss.

If these signs and symptoms sound familiar for you or a loved one, please talk with your healthcare provider and get checked out.

Raising Cervical Cancer Awareness (DRops of Wisdom)

Today we continue “DRops of Wisdom,” our physician blog, with Dr. Ron Schonwetter, chief medical officer for Chapters Health System. He describes the importance of raising cervical cancer awareness during the month of January.

January is Cervical Cancer Awareness Month

Over the last two decades, awareness of cervical cancer has grown significantly. This is due in large part to the National Cervical Cancer Coalition, whose mission is to help women, family members and caregivers battle the personal issues related to cervical cancer and promote prevention through community education. Subsequently, the U.S. government designated the month of January to also raise awareness about this form of cancer.

According to the American Cancer Society, approximately 13,240 new cases of invasive cervical cancer will be diagnosed and about 4,170 women will die from cervical cancer in the United States in 2018. Today, cervical pre-cancer is identified more often than the invasive form of cervical cancer.

Years ago, cervical cancer was one of the most common types of cancer that resulted in death for women in the United States. With the advent and increase in usage of Pap tests, the cervical cancer death rate decreased dramatically due to much earlier diagnoses.

How has this screening test helped? Before cancer even starts to develop in the cervix, a Pap test can recognize subtle changes. And if cervical cancer has started to evolve, this screening test identifies the change earlier on, when it’s easier to treat and cure. In 1971 when President Nixon signed the National Cancer Act and introduced the federal mandate “war on cancer,” the five-year survival of women with Stage 0 cervical cancer was less than 50 percent compared to 93 percent today.

Who is At Risk?

Women between the ages of 35 and 54 are most at risk for developing cervical cancer. It is rare in women younger than 20. Nevertheless, older women need to understand that they aren’t without risk as well. In fact, the percent of new cases of cervical cancer in women over the age of 65 is almost 20 percent of all new cases diagnosed.

In looking at ethnicity, Hispanic women are the population with the highest rates of cervical cancer. They are followed by African Americans, Caucasians and Asians.

What predisposes a woman toward cervical cancer? There are several risk factors that can increase a woman’s risk in developing this form of cancer.

Risk factors are:

Human papillomavirus (HPV): Over the last couple of years, there has been an increase in spreading the word about this most important risk factor for cervical cancer. Some individuals who are not able to rid their body of HPV develop a chronic infection, which greatly increases their risk of developing cervical cancer.
Weak immune system: As with other forms of cancer, a weak immune system puts individuals at high risk due to the fact that the body isn’t able to destroy or curtail the growth and spread of cancer cells or infections such as HPV. For example, cervical pre-cancer can rapidly become invasive in a woman who also has HIV.
Smoking: Any woman who smokes tobacco puts herself at almost double the risk of developing cervical cancer. Studies have demonstrated that the by-products of tobacco damage the DNA in the cervix. Smoking also can weaken the immune system in fighting HPV infections.
Chlamydia: This common bacterial infection gravitates to a woman’s reproductive organs. Like HPV, this infection is spread via sexual contact and most women do not experience any symptoms. According to a study published in JAMA, research confirmed a high risk of cervical cancer in women who had past or current chlamydia infections, which were then verified by blood tests and cervical mucus.
Family history: As with breast cancer, a mother or sister with cervical cancer increases a woman’s chance of developing this disease. This may be due to a family tendency to inherit the inability for women to fight off HPV infections.

What Would You Like to Read About in Future Posts?

In “DRops of Wisdom,” we want to feature posts with subject matter that interests you. Please leave a comment or email us with your ideas.

About Dr. Ronald Schonwetter

Dr. Ronald Schonwetter, Chief Medical Officer for Chapters Health System, manages hospice and palliative care services for the not-for-profit organization.

Dispelling 3 Cervical Cancer Myths

In our society, there always seem to be various topics that are fraught with myths and misconceptions. So today, we are tackling the topic of cervical cancer and setting the record straight.

Myth #1: Cervical cancer can’t be treated.

If detected and diagnosed early, cervical cancer can be treated effectively. Thus, it is very important to have routine preventive screenings even if no symptoms are present.

Myth #2: Older women don’t need Pap smears.

All women, who are 21 years or older, need periodic and regular Pap smears until the age of 65. After that age, women should discuss with their physicians the risks and benefits of ongoing screening based on their specific circumstances.

Myth #3: The Human papillomavirus (HPV) infection is not common.

HPV is common and the most important risk factor for developing cervical cancer. It is transmitted via skin-to-skin contact and bodily fluids. It is estimated that approximately 80 percent of Americans will contract HPV sometime during their lifetime. Oftentimes, people don’t experience any HPV symptoms, such as visible genital warts, and thus may never know they had/have HPV. Women learn that they contracted HPV when their screening test comes back positive. An abnormal Pap test can be related to HPV, but many times physicians don’t relay this information to their female patients. Therefore, many women do not know or understand the link between HPV and cervical cancer.

A vaccine to prevent HPV was first developed in 1991 by researchers Ian Frazer and Jian Zhou at the University of Queensland. It was then patented in the United States, and introduced as a tactic to combat HPV spread by the Centers for Disease Control (CDC). Today the CDC recommends that the vaccine be given to preteen girls and boys at age 11 or 12. The reasoning behind this recommendation is that these children will be protected before ever being exposed to HPV. This vaccine is actually a series of two vaccines given six to twelve months apart. If given over age 14, three shots are needed over a six month period.

Tips for Better Sleep

Do you have trouble falling asleep? Are you up night after night tossing and turning in bed? Or perhaps your eyes are focused on the clock on the nightstand as you watch the minutes tick further and further away from getting a good night of sleep? Lack of quality sleep can turn any person—from a patient with advanced illness to a caregiver—into a crotchety grouch who everyone avoids. Of course, on occasion, we have all been there before: Stress, family issues or a full gamut of worries can wreak havoc on our minds causing us to lose sleep. Nevertheless, better sleep is possible.

Making Better Sleep Possible

From top-of-the-line mattresses to infomercials about the best-of-the-best pillows, today’s society is constantly bombarded with commercials for ways to achieve better sleep. These measures, oftentimes than not, have high price points. However, you do not need to spend a lot of cash to grab a good night of sleep.

Keys to Better Sleep

The following are some simple and common sense tips that can help you get better sleep and will not break the bank.

Create a bedtime ritual.

Typically our minds and bodies are active all day. It’s no surprise that it can be quite a challenge to turn off or wind down and free the mind in preparation to end the day with much-needed rest. Developing a bedtime ritual that you perform every evening about an hour before your head hits the pillow can help.

Here are some suggestions to get you started:

Take a warm bath or shower, and use sleep-inducing soap scents like lavender and chamomile.
Read a book with a small reading light, or listen to an audio version.
If you have any current worries, put them into list form and develop a plan to deal with them the following day.
Listen to calming, meditative music.

Watch what you eat and drink.

Known as the first lady of nutrition, Adelle Davis said we should: “Eat breakfast like a king, lunch like a prince and dinner like a pauper.” If you follow these words of wisdom, you will not only have energy to give your day a jolt of unbridled energy, but also you will be able to sleep like a baby.

With this philosophy in mind, a big no-no that affects sleep is eating a heavy, large meal toward the end of your day. The food can put your stomach and intestines to work, which makes sleep more difficult. Additionally, it is smart to avoid fatty foods that stress your digestive system, and acidic or spicy foods late in the day can result in heartburn and upset your stomach.

What if you are hungry right before bed? There are some people who simply need a bedtime snack. Just make sure that the snack isn’t consumed at least an hour before going to bed. It is best to have a dairy or complex cab snack. Here are some suggestions:

Crackers and cheese
Granola with yogurt
Bowl of cereal with milk
Banana
Half of a turkey sandwich

It is also advisable to avoid alcohol before your head hits the pillow. Even though alcohol can act like a sedative, sleep can end up being restless with frequent wake ups. Another hint is to dial back the consumption of any beverage—water, juice, warm milk or even herbal tea. You can cut down on trips to the bathroom in the middle of the night if you stop drinking two hours before bedtime.

Limit caffeine intake late in the day.

Many people know the benefit of a jolt of java first thing in the morning. It often is the kick in the pants needed to get your day started. But as the hours of the day move toward evening, it is advisable to cut back on caffeine-infused beverages. Why? Caffeine remains in your system anywhere from three to five hours after consumption and causes your deep stages of sleep to be disrupted. And thus even a mere Tootsie Roll or decaffeinated coffee can affect your nighttime rest.

Improving your overall body and mind with exercise.

Studies have demonstrated that consistent exercise can improve the quality of your sleep. People who walk or perform any other form of physical activity tend to fall asleep faster and reap the benefits of deeper sleep. Before bedtime, yoga and tai chi are a perfect way to assist in winding down and relaxing one’s mind. However, it is important to not exercise intensely three to four hours before putting your head down on the pillow.

Keep pets in the bedroom but off the bed.

According to a Mayo Clinic research report, people who allowed one pet in their bedroom slept fine. However, better sleep can be achieved when pets are not sharing the bed. No matter if the four-legged family member is a dog or cat, pets can move around at night, which prevents a good night of sleep from occurring. Add to the mix that their bodies can be a haven for fleas, ticks, dander and pollen, sparking sleep-disruptive sneezing and nasal congestion.

Following these tips can help you keep the sleepless nights to a minimum. If these tips don’t solve sleep issues for you or a loved one, please talk with your healthcare provider.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Sleep Aging: Does it Break Down as We Get Older?

Myth or fact: As we get older we don’t need as much sleep? Most adults should still get the recommended seven to eight hours of sleep every night. Unfortunately, many adults often get less sleep than they need. How did this falsehood develop? Well, what does take place as we age is a breakdown in quality of sleep. Therefore, people are under the false impression that getting older means the need for less sleep.

Changes in Sleep Architecture

Sleep specialists describe what occurs as we get age as changes in our sleep architecture. Sleep is built normally upon various stages. Our nightly sleep cycle includes periods of light and deep dreamless sleep or active dreaming stages known as rapid eye movement (REM) sleep. In order to feel fresh and rested when we wake up, this whole process needs to happen periodically throughout the night.

It is inevitable that sleep patterns will change as we age. The following are some common factors that contribute to sleep breakdown:

Medical or psychiatric problems can create sleep loss: including medication side effects, sleep apnea, insomnia and more.
Adults may produce and secrete less melatonin, the hormone that promotes sleep.
Changes in the environment.

Aging can contribute to a more difficult time falling sleep and cause people to wake up more often during the night. It is important to remember that you always need a good night’s rest. You just need to realize that as you get older, sleep can become more difficult.

Seasonal Affective Disorder: Learning More about the Wintertime Blues

As fall melts into winter and the days get shorter, a seasonal health disturbance starts to increase. With fewer hours of sunlight during winter months, some people experience a serious mood change. Seasonal affective disorder, often known as the wintertime blues, is a form of depression that gains in prevalence during this time of year. Interestingly enough, there is a less common form of seasonal affective disorder that can develop in the summer months.

Who is Susceptible to Seasonal Affective Disorder?

If you think only people who live in northern climates and experience true winter weather—like bitter temperatures, snow and sleet—can develop seasonal affective disorder, you would be wrong. This form of depression affects people all over the world. According to Clinical Professor of Psychiatry Dr. Norman Rosenthal at Georgetown University Medical School, someone may have mild winter blues while living in a warmer, southern climate and develop full-blown seasonal affective disorder by moving north.

It is estimated that seasonal affective disorder occurs in 10 million Americans with about 10 to 20 percent being classified as mild. Prevalence ranges from slightly over one percent in Florida to nearly 10 percent in New England and upward of 14 percent in Norway. It is first seen in people between the age of 18 and 30. As with other types of depression, seasonal affective disorder occurs more often in women than in men—about four times more common. Severity of the disorder runs the gamut, which can influence quality of life even to the point of requiring hospitalization.

For many with seasonal affective disorder, there is a family history of psychiatric disease: 55 percent with a severe depressive disorder and/or 34 percent abusing alcohol. Of note, researchers at the University of California, San Francisco confirmed the existence of a genetic link, PERIOD3 or circadian clock gene, for this disorder.

What Are Seasonal Affective Disorder Symptoms?

From late November through the height of the winter months, symptoms of seasonal affective disorder will slowly increase with time and diminish by late spring/early summer. Many sufferers report they would like to “hibernate” for the winter. It is also important to note that seasonal affective disorder is NOT the same as the “holiday blues.”

The following are symptoms associated with seasonal affective disorder:

Irritability
Fatigue
Social withdrawal
Oversleeping
Weight gain with increased appetite (note: weight loss is more common with other forms of depression)
Feelings of hopelessness

Treatment for Seasonal Affective Disorder

It is important to know and understand that left untreated seasonal affective disorder can become long-term depression. Additionally, bipolar depression and suicidal thoughts are possible. Unfortunately, a specific exam or test to confirm seasonal affective disorder is not available. A diagnosis is made by determining the history of symptoms. A healthcare provider often will perform a physical exam and order blood tests simply to eliminate other disorders.

Lifestyle changes can help manage symptoms: getting adequate sleep, eating healthy foods, exercising often, participating in activities that make the person happy and talking with a trustworthy friend or mental health professional. For others who battle with seasonal affective disorder, light therapy is often a course of treatment. With light therapy, a special lamp is used to mimic sunlight. It is most effective to begin therapy before symptoms develop.

In 2017, studies were conducted to determine whether melatonin or tryptophan can be used to help move a person’s mood in a positive direction and improve sleep. Another study evaluated whether increasing vitamin D can prove beneficial in seasonal affective disorder. The results showed that more research is necessary to determine whether these options can be viable treatment options.

As always, if you or someone you know has thoughts of hurting yourself, get medical help right away.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Bomb Cyclone: Mother Nature’s New Weather Weapon

As the cold front continues to infiltrate Florida, you may have wondered what exactly was causing this unusual winter weather. Meteorologists are blaming it on what they call the “bomb cyclone” phenomenon.

According to the National Oceanic and Atmospheric Administration, a bomb cyclone, or “bombogenesis,” occurs when a big mass of cold air bumps into a big mass of warm, most air. This collision creates a lot of energy that causes the air pressure to drop dramatically triggering a very powerful cyclone. As the storm keeps moving north, the air pressure will keep dropping and it will get more and more powerful.

The resulting weather system is a defined as a “bomb” because atmospheric pressure drops very fast and the storm amasses devastating strength rapidly. As the storm intensifies, it draws more air in creating the eye of the cyclone.

Tips for Your Cold-Weather Safety

When it comes to cold-weather safety, we wanted to share some tips to keep you and your loved ones safe. You just need to follow the 5 Ps, which are:

People: Even in Florida, prolonged exposure to cold temperatures can increase the risk of hyperthermia. It is a medical emergency when your body loses heat faster than it can produce heat, and body temperature falls below 95 degrees.

If you are wet, even from sweating, hypothermia can occur. Therefore, try to minimize any time spent outdoors. If you need to be outside, make sure you dress in layers and cover your head.

Pets: Like humans, pets can also develop hypothermia. Do not leave pets outside. All pets need protection against weather elements. If you have a small or short-haired dog, keep them safe by dressing them in a sweater for walks.

Pipes: If you have any exposed pipes, there is an increased risk of freezing and bursting. As a result, water loss is possible and can create icy conditions on walkways. If you have an irrigation system, the same holds true. Be mindful of ice on sidewalks and on the road.

To prevent freezing pipes, let the cold water drip from the faucet that is supplied by the exposed pipes. Even a trickle running through the pipe can help prevent it from freezing.

With temperatures dropping potentially below freezing (32 degrees Fahrenheit), there is an increased chance of dangerous black ice forming on our roads. This phenomenon is called black ice as it tends to look like the rest of the pavement. You can use a car thermometer as a helpful indicator in monitoring road conditions.

Plants: With our temperature dropping into freezing range, outdoor plants can be killed, especially those that are not cold-tolerant. If possible, bring plants inside. As an alternative, cover plants for their protection against the elements.

Practice Fire Safety: Check all smoke and carbon monoxide detectors and their batteries. Space heaters can be harmful if care and common sense are not followed. Don’t leave space heaters on overnight when you sleep, and don’t plug them into an extension cord or power strip. And lastly, do not leave them on when leaving the room or home.

Stay warm and safe!

Spiritual Care at the End of Life

When faced with advanced illness or a terminal diagnosis, people tend to rely heavily on their religious beliefs and faith as a coping mechanism. At the same time, questioning faith can also be a focus as many grapple with the meaning of life at the end. Whether a patient follows a religion, spiritual care is of vital importance and integral to the hospice care plan.

Spiritual Care in Hospice

To understand the importance of spiritual care for hospice patients, one needs to understand the subtle differences between spirituality, faith and religion. According to the Oxford Dictionary, spirituality is a broad term defined as the “quality of being concerned with the human spirit or soul as opposed to material or physical things.” On the other hand, faith and religion are used to describe a person’s individual beliefs and practices, which can be part and parcel of spirituality.

More so now than ever before, we live in a society that is diverse. New York City is not the only “melting pot” of different cultures and religions. Throughout Florida, communities are a mix of people with different rituals and traditions. For instance, they can be Christian, Jewish, Muslim, Buddhist or Hindu, or not practice a religion and be agnostic or atheist.

No matter what a patient’s religious beliefs might be, the staff at any of the Chapters Health affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice—is respectful. The spiritual care staff members develop a unique rapport with patients and their loved ones and get to know their beliefs. By creating this bond of understanding, they can provide spiritual support—with words, prayers and music at crucial moments at the end of life.

End-of-Life Rituals and Traditions

As the end of life approaches, people gravitate to specific religious rituals and traditions. They can be divided into two categories: before and after.

Before death, many religions have rituals that prepare one for death. They can take the form of reading, praying, chanting, lighting candles, burning incense, meditating or playing music. Families and friends often visit and gather around the bed to pray and be with their loved one at the time of death.

After death, religions differ in the preparation of the body, including how it is done and by whom. Additionally, different religions vary when it comes to funerals, burial and cremation. It is also important to understand mourning practices among various religions.

Mourning Practices

Around the world, almost every culture and religion has mourning traditions. These practices are not a new phenomenon as archeologists have uncovered items like tools and jewelry buried with the deceased. Think and picture King Tut for example.

In today’s society, we have evolved into more refined mourning practices, which boil down to the same premise: It is our way of dealing with the death of a loved one.

The following are some examples of mourning traditions:

Catholicism: Traditionally, mourners wear black and many hold wakes, which take place between death and burial. Often, especially true in Ireland, the wake is held in the family’s home and is more accurately a celebration of the person’s life. The wake occurs typically along with the viewing of the body.

Judaism: People of the Jewish faith traditionally bury the body within 24 hours following death. The body is ritually washed and never left alone before burial. After the actual funeral, immediate family adheres to a strict mourning period of seven days, known as shiva.

Islam: Muslims also follow a specific period of mourning, which for family and friends spans three days. For widows, the iddah, or mourning, is longer and lasts four lunar months and 10 days. During this time, she is also not allowed to remarry.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

6 Tips for Spiritual Self-Care

Psychiatrist and neurologist Victor Frankl shared his observations as a concentration camp survivor in his “Man’s Search for Meaning.” He discovered that the inmates who survived were not necessarily the strongest but those who realized that, despite the suffering, life can be given meaning. According to Frankl, people can find meaning by giving something back to the world through creativity, interacting with their environment and others, and changing their attitude when faced with a situation that cannot be changed.

It doesn’t matter what your age or circumstance, everyone can create meaning in their lives. You just need time for yourself. Practicing self-care and making time to recharge your batteries can lift your spirits. Here are six simple tips to help you dispel negative energy and replace it with the positive, and thus allowing you to make the most of life.

Read a book. Whether it is a book that you enjoyed in the past or one that someone you trust recommended, take the time to read. And even better, read one that will be meaningful and resonate with you on a spiritual plane.
Tap into your creative side. Whether you enjoy writing, painting or playing an instrument, try capturing your thoughts and feelings on paper or canvas or through music.
Listen to music. Music touches everyone in personal and unique ways. It helps people recall a time in their lives when their hearts were filled with joy and fond memories. Additionally, a study published in the American Journal of Hospice and Palliative Medicine found that the multidimensional nature of music resonates with the needs of patients at the end of life.
Take time to watch a sunset, the stars at night or the sun rise. Observing the passage of time as it relates to nature can touch your soul to the core. And if you are able, walk in nature so that you can smell freshly cut grass, watch bees drink nectar from a flower or simply make a wish and blow on a dandelion.
Play your favorite childhood game. As a child, did you love playing Monopoly for hours? Or building wobbling Jenga® towers? Maybe throwing a little rubber ball down to pick up jacks was your favorite past-time? Try playing a game you loved as a child with sheer abandon and without judgment.
Connect with your soul through meditation. When someone feels stressed, it can adversely affect them physically and emotionally. For those who practice meditation, the mind is not as agitated, and thus you can become more focused and your concentration can improve. Meditative practice increases self-awareness and makes people more comfortable in their own skin.

When you take more time for yourself, your inner spirit will thank you.