A team of researchers at Ohio State University Medical Center has found a chemical marker in the blood that shows a significant increase under chronic stress and is linked to an impaired immune system response in aging adults. The team, led by Dr. Janice Kiecolt-Glaser, reports in the June 30, 2003 issue of Proceedings of the National Academy of Sciences on a 6-year study of elderly people caring for spouses with Alzheimer’s Disease. With the caregivers, the team found a four-fold increase in an immune system protein — interleukin 6 (IL-6) — as compared to a control group of non-caregivers. Only the stress of caregiving correlated to the marked increase of IL-6 in the caregiver group. All other factors, including age, were not significant to the outcome. Even the younger caregivers saw an increase in IL-6.

The study also found that the caregivers had a 63% higher death rate than the control group. About 70% of the caregivers died before the end of the study and had to be replaced by new subjects. Another surprising result was that high levels of IL-6 continued even three years after the caregiving stopped. Dr. Glaser proposes that prolonged stress may have triggered a permanent abnormality of the immune system.

The problem is if this response is initiated repeatedly over a long period; it can have a dangerous effect on the body. This repetitive initiation of the stress response is common among caregivers — especially those caring for loved ones with dementia. Providing supervision or physical assistance many hours a week and over a period of years turns out to be extremely stressful. This type of stress is often unrelenting, occurring day after day and week after week. And the long-term effects of this stress are more pronounced in middle-aged and older people who are precisely the group most likely offering long-term care to loved ones.

If you are a caregiver, please give us a call.  Through a properly-designed Life Care Plan for your loved one, the Farr Law Firm can help you minimize or eliminate much of your stress.

When someone is dying but there really is no hope for recovery, the family often calls 911 and starts a process which can result in great stress and great emotional discomfort. The loved one who is dying ends up in a hospital or nursing home in a strange environment, frightened and confused and tied to tubes and monitoring devices. This is not the ideal way in which to spend one’s last hours on earth.

Attending to a dying loved one in the peace and quiet of the home with caring children and grandchildren surrounding the bed can be a meaningful and spiritual experience for all involved. Hospice can allow this to happen. Memories of a loved one passing in peace can provide great comfort for family members in years to come.

When there is no longer hope for prolonging life, especially when this decision is made months in advance, hospice is a better alternative to other medical intervention.

Hospice is a form of medically supportive care for patients who are terminally ill. It allows for compassion and dignity in the process of dying. A commonly used definition for terminally ill patients is, “patients who have a progressive, incurable illness that will end in death despite good treatment, and who are sick enough that you would not be surprised if they died within six months.”

Hospice care is a valuable service and is generally underused except for terminal cancer patients.  Hospice involves a team approach using the following providers:

-Family caregivers;
-The patient’ s personal physician;
-Hospice physician (or medical director);
-Nurses;
-Home health aides;
-Social workers;
-Clergy or other counselors;
-Trained volunteers; and
-Speech, physical, and occupational therapists, if needed.

The purpose of hospice is the following:

-Managing the patient’s pain and symptoms;
-Assisting the patient and the patient’s family with the emotional, psychosocial, and spiritual aspects of dying;
-Providing needed comfort and palliative medications, medical supplies, and equipment;
-Coaching the family on how to care for the patient;
-Delivering special services such as speech and physical therapy when needed;
-Making short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time; and
-Providing bereavement care and counseling to surviving family and friends.

A person can receive hospice from Medicare if he or she is:

-eligible for Medicare Part A (Hospital Insurance), and
-the doctor and the hospice medical director certify that the person is terminally ill and probably has less than six months to live, and
-the person or a family member signs a statement choosing hospice care instead of routine Medicare covered benefits for the terminal illness, and
-care is received from a Medicare-approved hospice program.

A person may continue to receive regular Medicare benefits from his or her customary doctors for conditions not related to the hospice condition.  

Most families wait too long to have their doctor prescribe hospice from Medicare. Many doctors and families don’t consider this care alternative for Alzheimer’s, degenerative old age, or other debilitating illnesses where a person is going downhill quickly, but they should. If you or a loved one is suffering from such an illness, please discuss the possibility of hospice care with your physician. You can also contact directly one of our area’s local hospice providers, such as Capital Hospice (www.capitalhospice.org ) or Odyssey Health Care (www.odsyhealth.com ).