Search Results for: dying with dignity

By Maureen Rulison
Caregiver Support and Resources, LLC

There’s just something about owning an animal. It’s a responsibility, but pets bring so much life, light and love to environments that need it most. Animal-assisted care can be a great source of comfort and support for elders in good health and end-of-life patients alike. 

A well-trained service animal can serve as watchful eyes, a helpful assistant, calming presence and even a lifesaver. They’re becoming increasingly recognized as a valuable addition to the aging process and even dying with dignity. 

Studies have shown that animals can help reduce anxiety, depression and isolation in our beloved elders, while also providing a sense of purpose and connection to the world.

Animal-Assisted Care Can Help Loved Ones From Aging Gracefully Through End of Life

You may not think of a therapy pet being very helpful in life’s end stages. Your mental picture of someone dying – perhaps surrounded by family after a lengthy battle with cancer – probably doesn’t include a dog or cat.

That’s because you’re only thinking of end-of-life care as those final days. (Although, I’ve witnessed many times a dying individual feeling quite comforted by stroking the soft ear of a beloved pet.) But end-of-life isn’t just the “active” dying process. The weeks and months leading up to the end can actually be quite joyous and purposeful alongside a furry friend.  

Animal-assisted therapy involves the use of specially trained animals, typically dogs or cats, to provide comfort, support and companionship to individuals approaching the end in various health care settings. They’re trained to respond to cues from their handlers and are carefully selected for their friendly and gentle temperaments. They can assist patients in hospice care facilities, hospitals or even in their own homes.

Some of the benefits of animal-assisted therapy in the aging process and end-of-life care include:

1. Reduced Anxiety & Depression

Animals have been shown to reduce anxiety and depression in our aging loved ones, helping them feel more relaxed and at ease. This can be particularly beneficial for hospice patients who are experiencing pain, discomfort and emotional unrest. Studies have shown that the presence of an animal alone releases stress-reducing hormones in the brain.

A great therapy pet, where permitted, can make assisted living feel more like home.

2. Improved Mood & Emotional Well-Being

Spending time with animals goes a step further to even improve mood and other feelings of well-being. Aging in good health or bad is emotionally straining. It’s common to feel we aren’t “ready to go,” which can come with emotions ranging from deep sorrow to anger. Therapy pets help our aging loved ones feel generally more upbeat and engaged with the world around them. 

3. Emergency Assistance 

Service animals also play a vital role in emergency situations. In a medical emergency, a service animal can alert medical professionals or even call for help. You might even consider them a first responder of sorts. They can provide physical assistance to their owner, such as pressing the LifeAlert button, guiding them to safety or helping to navigate obstacles. 

Additionally, therapy pets can provide comfort during highly stressful situations like natural disasters or traumatic events. 

4. Enhanced Sense of Purpose

Caring for an animal can add meaning to life, helping our elders and even hospice patients to feel more connected. While your loved one is still mobile and aware, they may find purpose in minor chores like feeding and walking. Animal-assisted care can be particularly important for loved ones who feel they’ve lost their sense of purpose or identity.

5. Increased Socialization

Animals can be a catalyst for social interaction for our aging loved ones. Aging loved ones can feel lonely and isolated, even with family and friends coming around frequently. But taking a dog for a walk or sitting out in the sun petting a cat can improve mood enough to stir the desire to socialize with friends, neighbors and passersby.

6. Comfort & Companionship

A therapy pet doesn’t need to be a highly trained former police or military service animal to be effective. Sometimes their presence alone is a job well done. As with the reasons mentioned above, helping your loved one feel well is the ultimate goal – especially approaching end of life.  

Perhaps most importantly, animals can provide companionship to individuals along the aging journey – and all its ups, downs, twists and turns. Animal-assisted therapy is a source of unconditional love and support, providing elders with an ever-present sense of warmth and comfort.

7. Support for Care Partners

Animal-assisted therapy can also benefit family members and close friends who form your loved one’s care-partner team. It can help to reduce caregiver stress and burnout, and can provide a sense of connection and support to care partners struggling to cope with the challenges of elder care and the end-of-life transition.

Animal-Assisted Care: A Great Option for Everyone’s Health & Well-Being

If you are interested in incorporating animal-assisted therapy into your loved one’s end-of-life care, let’s make sure that’s an important element of their well-rounded life-care plan. Speak with your loved one’s health care provider or hospice care team. They can provide guidance and resources to help find a qualified animal therapy provider in your area. Or perhaps there’s already a longtime family pet that needs to be present, wherever your loved one resides.

With the help of a therapy animal, you can provide your loved one with the comfort, support, and companionship they need during this difficult time. As a professional life-care planner and a Board-certified Patient Advocate, I assist individuals and their care-partner teams every day. Caregiver Support and Resources, LLC can help you with this and other processes from beginning to end.

By Maureen Rulison
Caregiver Support and Resources, LLC

We prefer it, even if so much of it is centered around language alone. What is person-centered care? It’s a philosophy that empowers the individual at the center of care. Sometimes individuals, as couples later in life often prefer to trek the journey together. 

How is it so empowering? We’ll give some examples:

• My life partner/care partner, Brian, lives with Alzheimer’s and vascular dementia. He hates being labeled as a “sufferer” of dementia. Negative language itself places him at a disadvantage. He’s not a “sufferer.” He simply lives with the disease. 
• A wonderful woman living in an advanced-care facility complains about medication side effects. The doctor “in charge” of her care won’t listen and says, “It’s best for your condition.” Is it, though? With person-centered care, the woman directs her care, and it’s the doctor’s responsibility to use their expertise to find better options.
• A married couple agrees it’s time to research assisted-living homes. One spouse is becoming quite sick. The other is in great health. But they both wish to go in together. Their children disagree. Whose decision is right? With person-centered care, their choice should be honored because they believe being together improves their lives and care outcomes.

Person-Centered Care & Language Empowers the Individual

Now let’s break it down a bit further. It’s also referred to as person-focused or person-directed care. Tomato/to-mah-to – they accomplish the same thing: empowerment over care decisions and everyone’s God-given right to live and die with dignity.

Here’s how.

A Voice & Choice in Care Decisions

Once upon a time, in a galaxy not so far away, medical professionals called all the shots. They analyzed, made a decision and ordered it done. Now, of course, there are still medical professionals who operate this way, but the overwhelming trend toward person-centered care is rendering those methods obsolete. 

Yes, doctors, nurses and other pros in the continuum of care have years of education and experience that we must consider and respect. But who knows their body and mind better than the person living in it? Who knows how it feels? Who knows how it reacts? That’s right: you and/or the loved ones entrusted with care decisions. Care isn’t being given from a higher power. It’s being coordinated by equal voices. (Helpful hint: With some great life-care planning, person-centered care allows people to speak for themselves even after they can no longer speak.)

Words Matter

Person-focused language is compassionate. Our loved ones deserve that compassion – whether they’re aging in good health or bad. It’s fair. It’s balanced.

Terms like “caregiver” aren’t as fair and balanced as the person-focused term “care partner.” “Caregiver” connotes a superior relationship between a person who is “more capable” and one who “can’t care for themselves.” While “care partner” connotes an equal relationship – a “partnership in care.”

The list goes on:

• “Resident” – someone who lives in a place vs. “Patient” – someone dependent on care.
• “At risk for falls” – someone who may fall vs. “Falls risk” – a demeaning label.
• “Prefers not to” – expresses personal will vs. “Non-compliant” – a label of insubordination.
• “Facility” – an institutional setting vs. “home” – a place of comfort and healing. 

Person-centered language removes labels and restores power where it should be: with the individual.

Building Your Circle of Support

What is person-centered care if not a way to mobilize the people, programs and professionals that’ll make life easier? The individual has the power. They know best. They know who knows them best and will provide the most effective and fulfilling life care. 

Your loved one sits at the center of the care-partner circle. They receive care, of course, but with person-focused care, they have the most important job: directing care. Everyone else surrounding them – from siblings and spouses to doctors and faith leaders – play equally vital roles providing love, support, guidance and medical treatment.

Reversing the Stigma

Along the same lines as person-focused language, this care philosophy does a fantastic job changing negative perceptions about aging and illness. The stigma, if you will.

A lot of this stigma can be attributed to culture and media. It’s hard to feel good about oneself when the global narrative glorifies youth, beauty and fitness at every turn. Thus, recognizing age and illness as natural human processes becomes more difficult. Who wants to be seen as “ugly” and “frail”? But getting older isn’t ugly, and illnesses we don’t choose aren’t weaknesses. Person-centered care, in turn, recognizes and honors our loved ones living through the reality life throws at everyone eventually.     

Different Strokes for Different Folks

Sometimes seeking alternative approaches and perspectives – thinking outside the box – yields better results. You’re correct in requiring other options and opinions. Under person-centered care, health professionals are obligated to use their expertise to provide those alternatives themselves (or at least indicate the right direction).

This empowers your loved one during doctor visits and other wellness consultations. Years ago, top-down approaches and one-size-fits-all treatments relegated care recipients to obedience. “Follow the doctor’s orders” was the common phrase. But no one, professional or not, should dictate care beyond the individual themselves.

So What is Person-Centered Care? It’s a Gateway to Better Care … On Your Terms

People aren’t defined by their care needs. Those who provide care aren’t in charge. The person-centered care philosophy – in both words and actions – restores power to the individual. Our good friends at the Pioneer Network and Eden Alternative have led these culture-change efforts for decades.

And here at Caregiver Support and Resources, LLC, we explore all paths to person-centered care through Board-certified Patient Advocacy, life-care planning and more. We’re happy to guide the process in a caring and compassionate way. 

Email me at maureen@caregiversupportandresources to discuss your needs – because we value you as an individual.

By Maureen Rulison
Caregiver Support and Resources, LLC

Planning for every part of the life journey is never easy. Many of us retire and think the planning’s done. But there’s even more to factor in a strong, comprehensive life-care plan that factors your (and/or your loved one’s) care needs and dignity through the end – and beyond.  

Here at Caregiver Support and Resources, LLC, we build plans that empower care decisions to the right people – you and yours. The life-care plan isn’t just a means to “the end.” It’s a roadmap to prepare for unexpected emergencies, build financial security, and provide the comfort and LIFE WORTH LIVING to which we are all entitled.

A Great Life-Care Plan Has a Lot of Moving Parts

Numerous elements should comprise a life-care plan, which lays out what will be done, when, why and by whom. It factors everything that can – and should – happen. We’ve said before there should generally be 9 parts to a great plan, but each individual and family is different. (So if your life-care planning takes 15 extra parts, so be it!)

In a nutshell, this document spells out everything that needs to happen as care-partner teams navigate the uncertainties of advancing years, health conditions, financial and legal realities, and end of life. 

Even though everything is clearly laid out, make sure the plan is flexible. Be sure to anticipate changing realities, needs and wants over time. Care partners and responsibilities may change. Unanticipated medical diagnoses may arise. Financial security can teeter on the brink.

In general, the following are strong elements to include.

1. Care-Partner Team

Let’s begin with the circle of support surrounding the person(s) receiving care. Members may consist of family, friends and professionals in the continuum of care (primary care physicians, specialists, mental health counselors, assisted-living administrators, etc.). The team may be expansive, or it may be a team of one. 

The non-negotiable: the team must adopt a spirit of mutual cooperation and accept joint responsibilities. There are opportunities to give (and receive) care by everyone:

• A sister may tackle financial needs.
• A son may stop by to prepare meals and sort medications for the month.
• A neighbor may visit frequently for coffee breaks (aka wellness checks).
• A husband may assist with bathing and bedtime routines.

Your care-partner team may also include non-traditional and spiritual care methods. Some families prefer life-care plans that honor their religion and faith, with a clergy member or spiritual adviser assisting appropriate areas. 

2. Medical Care

Health is the most important factor – even if it may be deteriorating or failing. Medical concerns can arise in good health and bad. Illness can derail even those who seem the most healthy. 

Your life-care plan must factor anticipated health and dietary needs. These may vary person by person, year to year, month to month, or even day to day. So the plan must lay out what’s to happen in the status quo and when health matters inevitably change.

3. Financial & Legal Protection

Achieving a LIFE WORTH LIVING is so much easier when all the “loose ends” are handled. So let’s make one of the first things tackling the immense stress of financial and legal uncertainties. You want to know your “house is in order” to ensure legal control if/when the individual becomes incapacitated and protect assets for future generations. 

Ideally, official documentation will be prepared well before “when the time comes.” It’s more than “who gets what” or who chooses to “pull the plug.”

Needs may include:

• Medicaid and VA planning (with asset protection)
• Estate planning
• Living will (or advance directive) 
• Power of attorney
• Health care proxy
• Last will and testament

As always, get it in writing! Get it done early, when everyone has a calm mind about the future, less inhibited by reactionary biases. 

4. Living Situations

Home is where the heart is, but that may not be the case if/when medical concerns worsen. A strong life-care plan defines where your loved one will reside, when and why. 

It should have a Plan A and contingencies for both anticipated and unforeseen variables. For instance, Plan A may be that your Dad lives at home with your Mom, but Plan B might include options for Mom entering memory care when her dementia takes a turn, while Plan C mobilizes home-care resources for Dad remaining at home before moving to join her in Plan Z.

Moving to some sort of assisted living or advanced care isn’t always inevitable, but it is highly probable. More than 800,000 Americans reside in assisted living facilities – even more in advancing levels of skilled nursing. The trick is knowing when to make that call. When you or your loved one needs full assistance walking, bathing and toileting, that’s usually a good sign to go.

5. End-of-Life Care

We all owe God a death. That’s reality. But less than 40% of adults actually prepare for end-of-life care. And that’s a shame, considering it may be a prolonged, painful experience – even for the healthy.

Hospice care is a great resource for individuals with terminal illnesses expected to live six months or less, providing comfort and support on the journey to the end. For those expected to live longer in a debilitating condition, palliative care provides many of the same comfort services. 

(Related reading: What’s The Difference Between Hospice & Palliative Care? And Don’t Wait for Important Conversations About Hospice.) 

6. Person-Focused Care

It begins with the very language we use. Words are our most powerful tools. They can help or cause damage. Words can empower or place the care recipient in a weakened position. “Person-centered” or “person-focused” is the name of the game. 

Referring to a person as a “care partner” rather than a “caregiver” is a more calming and equitable relationship. While in the common vernacular, the term “caregiver” implies authority. Similarly, calling someone a “patient” connotes placement and dependency versus a “resident” who directs their care.

7. Community Resources

Extending to the outer circles of the care-partner team and beyond, many communities have ample resources (if only one knows where to look). Great care is a team effort. Community care options, including professional agencies, may include:

• Home care
• Respite care
• Counseling 
• Real estate
• Spiritual and faith-based care
• Living transitions and logistics
• Legal planning
• Even cleaning and cooking

In addition to part of our patient advocacy and life-care planning, we provide referrals to great resources in the Tampa and Clearwater, FL, areas.

8. Patient Advocacy

Which segues nicely to this point. Patient advocacy is another available resource for a well-rounded life-care plan. It’s your one-stop shop for EVERYTHING your loved one and care partners need. 

Our loved ones will be faced with many important decisions. An experienced Patient Advocate will know each required step for your loved one’s physical, emotional and financial well-being. As a Board-certified Patient Advocate in the State of Florida, I work with care-partner teams to support every step of the care journey.

9. After Care

The end has come, and the family is grappling over the loss of a loved one. Whether your loved one passed in peace or struggled mightily, the death experience can be jarring for everyone involved. The emptiness and sorrow can be incredibly strong, especially for close family and friends. Sometimes only counseling can work through such powerful feelings.

Memorial services and other final arrangements, as well as fulfillment of financial and legal responsibilities should also be included in a life-care plan. Alongside our community partners, we provide direct after-care support and referrals after a death. 

Let’s Build a Life-Care Plan for a Life Worth Living

As a professional life-care planner and a Board-certified Patient Advocate, I assist individuals and their care-partner teams every day. And then I come home to fulfill our life-care plan with my life partner/care partner, Brian. If you need help, Caregiver Support and Resources, LLC can help you from beginning to end. Email me at maureen@caregiversupportandresources.com.