Why is Hospice Taboo?

When patients or family hear the word ‘hospice’, it triggers a cascade of defense mechanisms. What they know is that Hospice provides symptom management for the last 6 months of life. What they may not know is that Hospice is a wholistic service with your loved one at the center. As a health care provider, I realize there is a taboo surrounding the word hospice. I want to clarify what hospice is, and why it should be presented to everyone with a terminal diagnosis as an option.
Hospice, by definition according to merriam-webster is “a program designed to provide palliative care and emotional support to the terminally ill in a home or homelike setting so that quality of life is maintained and family members may be active participants in care; also : a facility that provides such a program”
Yet, without knowing the definition of Palliative Care, this may be confusing. Palliation is the relief of symptoms. With terminal illnesses, people often have many uncomfortable symptoms. These symptoms are what lead people to seek medical treatment. They can be pain, nausea, vomiting, constipation, or even a lack of appetite. In hospice, the primary goal is to make the person comfortable, always. This is done by alleviating of the symptoms through medicines (even unconventional medicines) and alternate therapies. Hospice also addresses the emotional aspect of it. Whether that be through a chaplain, a counselor or an empathetic nurse. Many times, the hospice provider will follow up with your family for years to come.
What is most important is that the person receiving hospice care is in control of their care. Meaning, if the person wants to eat salty french fries even though they have high blood pressure, that is ok! If they are weak but want to get up, let them! If they want to live on a diet of sweets, even though they have diabetes, that is ok too! Or, if they want to continue living on a diabetic diet, that is fine too. The emphasis is on quality of their days left. Quantity, is something that is never guaranteed. No healthcare provider can predict how many days a person has left. But a person, with the support of a hospice team, can determine the quality of life on a day to day basis.

Hospice is not taboo, it is a gift.

It hurts finding out that you or your loved one have limited time left on this earth. It is a bitter pill to swallow. The next step is to find out how you can maximize the time that is left. Time is unpredictable, but you can make the most of it with Hospice. Hospice is not taboo, it is a gift. Everyone with a terminal illness should consider it as a treatment option. It is not giving up, it is maximizing the time left.



Is My Fitness Routine Enough?

The fitness googling binge: searching fitness routines for hours endlessly until we find ourselves deep in the internet without ever finding the answers we need. We started off with “How to be healthy” and ended up on a blog that sucks you into buying their PDF fitness routine with false claims.

This is a battle that I, my friends, family and patients cycle through often. We feel like our fitness routine is not enough. We are not losing enough. We are not moving enough. We start one plan, stick with it for a few days, fall off and feel guilty. Back to googling.

Perhaps we do not stick to a fitness plan because it is actually too much. It makes our bodies tired. It’s difficult to incorperate into our daily lives. We blame ourselves, but I think it is important to look at what is enough?

Currently, many organizations like the American Cancer Society and the American Heart Association are in agreement. Enough exercise can be 150 minutes of ‘moderate exercise’ per week, or 75 minutes of ‘vigorous exercise’ per week. Let’s break this down.

  • 150 Minutes of Moderate Intensity Exercise

150 minutes over a course of seven days could be roughly 20 minutes per day. Or, 30 minutes Monday through Friday. Or, three 50 minute moderate exercises in a week.

Do these numbers seem more manageable? Let’s explore what ‘moderate intensity’ means.

According to the World Health Organization (WHO), examples include:

  1. Brisk walking, walking domestic animals
  2. Dancing
  3. Gardening
  4. Housework like chores or painting

Anything that has your heart at an increased rate could be included. Things like yoga, playing at the park with your child, or walking fast to catch your bus can elevate your heart rate.

  • 75 Minutes of Vigorous Intensity

In a seven day period, this could be 3 days of 25 minute exercises. Or, even 5 days of 15 minutes vigorous exercise. Maybe you do a spin class for 60 minutes one day a week, and a 15 minute HIIT workout two days later. You are meeting your quota!

Our experts at WHO define Vigorous intensity as:

  1. Running
  2. Cycling
  3. Fast swimming
  4. Competitive Sports

My message is this: You are doing enough!  If you missed a workout, but are still walking to work everyday, it is okay! If you meet these guidelines, you are on track to a healthy life. At a minimum, I know that I am taking my dog for a walk about 20 minutes everyday, and sometimes twice a day. This reinforces to me that even if I skip out on a gym session, I am still doing enough to maintain a healthy life. For the less leisurely, or those who enjoy a good sweat but maybe not everyday, you are probably doing enough too. Cut yourself some slack, and celebrate that you are active after all.

For those who are trying to achieve their ideal body, perhaps this is not enough. But for my patients and myself, I am most concerned about living a long healthy life. Examine your goals, and celebrate your accomplishments.

Disclaimer: let’s not forget that a healthy lifestyle is coupled with eating right too. Exercise alone is not enough. More to come on eating right in the future.

Did you notice that your daily routine may be enough to live a healthy life? Tell me about it in the comments!




Welcome to the coffee break clinic!

Last week, I spent an hour in my patients room, speaking to him and his family about chemotherapy and how it works. To watch the look of fear transform to the look of empowerment was energizing. I too stepped out of that room refreshed. It was a reminder of why I became a nurse in the first place: patient education! I am here to expand my reach, to provide quality information based on the literature in a way that is easy to understand. I am an oncology nurse, and a nurse practitioner in training. I specialize in primary care, adult gerontology, and oncology. I care deeply about people and am here to share my passion through writing.

Here is what you can expect from me:

  • posts supported by evidence in the literature
  • topics relevant to health, well-being and prevention
  • support where ever you are in your health journey

Above all, I am putting myself out there to get to know others in the health and wellness community. Survivors, caregivers, health care providers, or hobbyists – I want to meet you!

Do you have any topics of interest? I have hundreds of ideas but am open to answering questions too!