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Deciding on hospice care for a loved one is a deeply personal and challenging decision, balancing their wishes and medical realities. Rebecca Edwards, DNP, from Renown Hospice Care, explains the signs indicating when it might be time for hospice and offers guidance on navigating this decision with compassion and clarity. Understanding Hospice Care  Before exploring the decision-making process, it’s crucial to have a clear understanding of what hospice means. Hospice care represents a shift in how we approach living with a terminal condition, emphasizing comfort, dignity, and quality of life above all else. When there is no longer a pathway to a cure, side effects of treatment outweigh the benefits, or someone is simply tired of frequent hospital visits, then it may be time for hospice. Hospice care is mainly done in the home, where most people wish to be. It's a compassionate, team approach to care that focuses on meeting the physical, emotional, and spiritual needs, supporting their families, and honoring individual preferences. 5 Critical Signs to Be Aware Of Decline in Overall Health: When a loved one's health continues to decline despite ongoing medical interventions, this may be a sign that these treatments are no longer effective.  Increasing Pain and Symptoms: When managing symptoms such as pain, nausea, fatigue or shortness of breath becomes increasingly challenging, hospice can offer specialized support and expertise in symptom management.  Frequent Hospitalizations: Repeated hospitalizations or emergency room visits can signify that the disease has progressed to a point where managing symptoms and providing comfort at home or in a hospice setting is a more appropriate approach.  Difficulty with Daily Activities: If your loved one is experiencing difficult with activity of daily living such as dressing, bathing, or mobility, it may be a sign that they require additional support and assistance. Prognosis of Six to 12 Months: Hospice Care is typically recommended for patients with a prognosis of about one year or less if the disease follows its normal course. However, it’s important to remember that every individual is unique and prognosis can vary.

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Compassionate Care in the Comfort of Your Home Welcome to Renown Hospice, where compassion meets comfort in life’s most tender moments. Renown Hospice is a not-for-profit hospice, founded solely on a mission to care for and support those in our community. With a dedicated team of professionals and comprehensive services provided in the comfort of your home, our hospice program is one of the highest-rated quality care and experience agencies in northern Nevada.   At Renown Hospice, we provide specialized care that focuses on providing comfort and support to individuals who are facing a life-limiting illness or nearing the end of their life. Our primary goal is to enhance quality of life by addressing physical, emotional and spiritual needs. Our hospice care emphasizes dignity and respect, empowering our patients to make choices about their care and treatment preferences.  As you embark on the journey of navigating end-of-life care for yourself or a loved one, we extend our heartfelt support and guidance. Please note our team is available 24/7 to answer any questions and schedule an evaluation with one of our Renown Hospice nurses.

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Cost-saving isn’t the only reason to enroll in a Medicare Advantage Plan. One of the main reasons Medicare beneficiaries in Nevada join a Senior Care Plus Medicare Advantage Plan is for the care coordination services. The Senior Care Plus Care Coordination team helps members navigate what can be a complex healthcare system. Care coordination is a popular and extremely important service for members because keeping members healthy is the number one goal. One way they help reach this goal is to encourage members to participate in a no-cost, comprehensive health assessment. At this Quick Start Health Assessment, members meet with a geriatric specialist – a provider who specializes in the care of seniors – to discuss the 4 Ms: Mentation – Thinking, memory and mental health Medications – Understanding your medication Mobility – Staying physically active What Matters to You – Let your provider know what is important to you – examples could be family, health and independence The results of this detailed visit are then shared with the member’s primary care provider, so a customized care plan can be developed. This is a free service for Senior Care Plus members, along with an annual wellness visit and an annual physical exam. Care Team Approach – Laying the Foundation to Improve Health Health assessments and annual visits are offered so Renown Health providers can build relationships to improve care. This approach, also known as the Building Relationships to Improve Care or BRIC Model, is the care model used across Renown Health. “What’s special about this care model is that it really puts our patients at the center of their care,” says Savannah Gonsalves, a registered nurse with Senior Care Plus. “Members have their providers and nurses, Senior Care Plus personal assistants, case managers, and within the BRIC Model, they’re all talking to one another and putting the focus on the patient to meet needs.” Personal Assistants – A Unique Connection to Each Member A team of personal assistants is available to help members coordinate care by: Scheduling a member’s appointments Answering a member’s benefits questions Helping navigate care – these are experts in both health insurance and healthcare Answering questions about medications Working with providers to coordinate a member’s care The Senior Care Plus personal assistants are one of the most popular services that the Medicare Advantage plan offers. Each personal assistant has a direct phone line so members can call them to ask questions. “After my hip surgery my personal assistant, Megan checked in on me every day,” recalls Janelle, a Senior Care Plus member. “She made sure that I was doing alright and that I didn’t need anything. She just let me know that she was there for me.” To Learn More Senior Care Plus is the largest Medicare Advantage Plan in northern Nevada. They offer $0 plans with low co-pays with access to Renown Health and Teladoc Virtual Visits that cover you nationwide. To learn more about Medicare Advantage plans and to see if you qualify, visit SeniorCarePlus.com or call 775-982-3158 to speak to an enrollment specialist.

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Renown’s Sterling Silver Club is honored to feature one of our more than 9,000 members each season. We thank Judith for sharing her inspirational story and all of our members for leading healthy, happy lives that inspire us all.     Mother, grandmother and eventually great-grandmother is the expected title progression as families grow and babies have babies. “Grand” and “great” usually imply roles and responsibilities have shifted from daily child-rearing duties to those of a doting grandparent – that is, unless you decide to do it all over again. At the age of 61, that’s exactly what featured Sterling Silver Club member, Judith, decided to do when she adopted four of her great-grandchildren. At the time, Alicia, Adrianna and Joey were all under five and Giancarlo, the youngest, was just a baby. “At the adoption hearing, the judge was concerned how stressful it would be for me to raise four children in my late 70s and early 80s,” recalls Judith. “But I told him I had raised my own four children and then three grandchildren for a number of years and that it would be far more stressful for me to have my great-grandchildren separated from each other and me, possibly forever. I knew I could handle the stress of raising them no matter my age, but I couldn’t survive the stress of losing them.” “That was when Giancarlo started getting fidgety,” she continues. “So I raised up his little shirt and blew a raspberry on his tummy which made him giggle and settle down. Seeing that, the judge told the recorder to “put that move in the record” and agreed I was capable of caring for my little ones.” Years later, Judith has come to realize that her great-grandchildren also want to be there to care for her. “Giancarlo always makes me smile,” says Judith. “Once during a stay in the hospital, I was awoken at 3 a.m. for blood work and found him sitting next to my bed watching the oxygen count – he was 10 years old at the time.” “The nurse asked him why he was awake and he said he heard her say the count shouldn’t go below 88, so he was watching to save me if it did,” Judith explains. “The nurse reassured him that she was also watching the count at her desk and he didn’t need to worry. Then Giancarlo looked her square in the eye and told her if it went below 88 to wake him up because he loved me and didn’t want to lose me.” “He is still my sunshine,” Judith smiles. “And I have never regretted my decision.”   Work & Play For 20 years, Judith worked at Truckee Meadows Community College (TMCC), first as an administrative assistant for the police academy before moving to a position in the president’s office. There she worked with the TMCC Foundation and on TMCC projects to raise capital funds for new buildings, off-site campuses, scholarships, college programs and more. “It felt wonderful to be able to notify a student that they had received a scholarship or tell a department that they had received the funds to purchase needed equipment for their program,” recalls Judith. For fun these days, Judith still enjoys doing something she did as a teenager: playing pool. “My mother taught me to play pool in my dad’s pool room/teen hangout space in my early 20s and I’m just getting back into the game by taking lessons to help remind me what I was taught,” says Judith. “I grew up in a small, country town on the Ohio River and my mother could beat almost all of the boys in the county. I would love to be able to emulate her ability in the game.” Judith also enjoys reading, watching Hallmark movies or Warriors basketball games, walking in nature, playing “competitive” shuffleboard with friends, all genres of music – and dancing! In fact, she’s currently taking dance lessons to learn a few new steps. Always Good for a Laugh “My great-grandchildren and I laugh a lot when I try to teach them the stroll, twist, mashed potato and old-fashioned, rock-‘n’-roll dancing,” admits Judith. “But we laugh even harder when they try to teach me their dance moves!”   Faith in What Matters Faith is something Judith celebrates and embraces for herself and others. “I truly believe that we are placed on earth exactly where God feels we are needed and that we are here to help each other through life, not to accumulate material goods for ourselves,” says Judith. “I feel deep satisfaction when I can help others either through just listening to them, advising them, helping them with specific needs or simply giving a smile to a stranger. To me, giving a smile or a helping hand to someone is like skipping a rock across the water – the ripples go on and on.” Then she adds, “And raising my great-grandchildren to be able to have wonderful lives full of love and happiness and closeness to God is the greatest gift I could give them.”   Club Talk So what does Judith appreciate most about being a member of the Sterling Silver Club? She says it’s the opportunity to just – talk. “I fully enjoyed my initial interaction with the club and other club members at the Roaring Twenties dinner dance event,” remembers Judith. “I sat at a table with the nicest ladies and had great conversations with adults and danced with one of the instructors. When you are raising four teenagers who sometimes seem to speak an entirely different language, it’s refreshing to meet and speak with others your own age.” Pictures of some of the popular Sterling Silver Club events are featured here. Judith finds club events that bring her joy. “I also like the cooking classes and recently went on a walking tour of Oxbow Park, which was very peaceful.”     What advice does Judith have to help other members live their best and fullest lives? “On a wet December morning 50 years ago,” Judith begins, “a truck coming around a curve on a country road slid into me and that split second could have made all the difference in the world to me. But God was with me and I survived, which no one expected.” “You never know when that one second that could change everything might happen, so make the most of all of your seconds,” she advises. “Do what you love with those you love. My family means the world to me and I try to think about how my decisions will reflect on the memory I will leave behind for them.” Then Judith thoughtfully adds, “I want them to remember that I truly loved them and always did my best to let them know that.”

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Becoming a caregiver or playing a more active role in another’s healthcare is a big responsibility. At some point, almost all adults will support an aging parent or a loved one in need. Keeping track of their needs and wellbeing, while also prioritizing your own can become overwhelming. It’s important to know: you are not alone, and help is available. Read on for 11 tips to help you manage your time, your own wellbeing and your loved one’s care. Self-care comes first. When your main priority is the person in your life who needs care, it’s easy for your own needs to take the backseat. Give yourself time each day to focus on your personal wellbeing. It’s hard to give a loved one the care they need if your own needs are not met. Prioritize the Activities of Daily Living (ADL). Make a note of what ADLs your loved one can do alone, what they need help with and what activities require the most help. This will help you work through the day with them, as well as plan out how the day’s activities will go. Do a home safety audit. Do showers, bathtubs and steps have safety grab bars? Look around the house for additional tripping hazards, like rugs or electrical cords. If your loved one struggles with day-to-day navigation of the home, consider scheduling an occupational therapy appointment. This type of therapy helps a person develop or maintain the motions required to accomplish daily tasks. You might also qualify for a referral to in-home healthcare, such as Home Care. Have the hard conversation. The best time to discuss views about end of life care and to learn what choices are available is before a life-limiting illness or crisis occurs. With advance care planning, you can help reduce the doubt and anxiety related to decision making at the end of life. Completing an Advance Directive is a great tool to sort out all these decisions before they’re needed. Attend a free workshop to learn more and complete this important document. Identify when you need respite. Respite care involves receiving a short-term break from caregiving. Organizing in-home care for your loved one will allow you to step away and tend to your needs. By identifying what kind of respite care you are seeking, you can find the right person to provide you with that much-needed break. Don’t wait until you feel overwhelmed, plan ahead. Write down insurance contact information. Have a direct connection to the right insurance professional for support and advice. If your loved one is eligible Medicare, this is a good opportunity to review their current selections and if they would benefit from a Medicare Advantage Plan or Medicare Supplement Insurance. Seeking out expert advice or information on Medicare options is a great way to navigate this. Consider calling a broker, or attend a free educational seminar with Senior Care Plus. Gather legal and financial information. Make a list of all existing legal documents and financial accounts that your loved one has. These might include a will, advance directive, power of attorney, bank accounts or investment accounts. If you have questions about how to manage them, or need assistance in setting up additional framework, reach out to a lawyer, legal service, financial adviser or bank representative. Create an inventory of medical information. Identify where all of your loved one’s medical records are, as well as a list of providers or healthcare practices where they have received care. Consider if you should have your loved one give you Proxy Access in MyChart, which allows you to access all the features in MyChart on their behalf, including viewing upcoming appointments, viewing test results and emailing a doctor on their behalf. Make a list of what others can do. Think about all the little (and big) things that need to happen, and write down tasks that others could take care of you. When someone says “let me know what I can do” you’ll be ready with a pre-written list of items they may be able to assist with. Tasks could include tackling around-the-house repairs, scheduling lawn work, helping to walk the dog, taking a car for an oil change and cleaning. Find programs and events for social enjoyment. If and when possible, seek an activity outside of the home. Look for community centers that have programs for seniors, recreational activities or meals that you can patriciate in together. If leaving the home is not an option, arrange for visits or in-home activities, such as movie nights, card games or time to visit with family. Research long-term options. If you will be considering a nursing home or assisted living, make a list of amenities that you and the person you are caring for would like. Take this list with you when visiting potential locations to make sure you don’t forget to ask about each item.

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