Archive for August 2019

Loss of Appetite When Dying Explained

Posted on Aug 02, 2019

holding elderly hands

Why do the dying lose their appetite? 

The digestive process can be fairly taxing on the body. The process of breaking down foods or even processing nutrients require a level of energy that the dying person may just not have. One way even the healthy may have experienced this is growing nauseous or even vomiting following an intense physical workout. During an exhaustive workout, the body reallocates resources such as blood and energy to the muscle groups and organs that require it most. This leaves the digestive system with limited energy, thus frequently inducing nausea or vomiting because it is unable to process the food at the moment. A dying person’s body is reallocating similarly limited energy supplies to keep the essential systems of the body working. Because of this, their bodies lack the strength to digest food, thus making the presence of that food or fluid in their systems uncomfortable or even intolerable. 

Do people ultimately die of starvation? 

It may seem like a loved one towards the end of life who has not eaten perhaps in days or even over a week is essentially dying of starvation. This is not the case. The person will eventually pass away due to their illness. It is important to remember that it's not they have simply given up on life and chosen not to eat or drink, but they simply can’t and often do not want to. 

Isn’t it painful not to eat or drink while dying? 

Most of us can hardly imagine going more than a day without eating. The dying, however, typically do not experience discomfort associated with not eating or even dehydration besides possibly a dry mouth. Once dehydrated to a certain degree, the brain frequently releases endorphins that block many pain receptors — a kind of built-in pain-killer system. These endorphins can even induce a euphoric feeling. Artificial nutrition, on the other hand, can induce a form of false hope for the body, allowing it to continue to fight to stay alive — a painful, hopeless fight that typically only prolongs the dying process. 

If you would like more information about hospice or palliative care in the Tulsa area, you’re invited to learn more about and reach out to the caring professionals at Cura HPC. 

Does Morphine Hasten the Dying Process?

Posted on Aug 02, 2019


The purpose of morphine and other painkillers throughout the dying process may seem fairly clear — to relieve pain. While this is true, morphine and other related opiates (such as codeine, hydromorphone, or fentanyl), have another purpose: to decrease the shortness of breath among the dying. Also known as dyspnea, short or labored breathing is a common experience among those in the dying process. While not necessarily painful, symptoms of dyspnea are uncomfortable and can greatly induce feelings of distress or anxiety. As somewhat of a catch 22, the anxiety surrounding dyspnea can exacerbate the symptoms and make breathing even more difficult. In order to provide relief from these symptoms, opiates such as morphine may be used to help alleviate both anxieties as well as the shortness of the breath. 

Can Morphine Speed Up Dying? 

Some families of the dying or even the dying themselves may have some reservations against using morphine and other painkillers to decrease breathlessness. There is an erroneous idea that morphine hastens the dying process. Part of this misconception is from experiences where death was immediately preceded by a dose of morphine. This is an important time to remember that correlation does not imply causation. The doses of morphine given to the dying are of relatively low and do not directly hasten death. Doses are given in relation to the person’s breathing needs and levels of discomfort. The purpose of hospice or palliative care is not to bring about death, but to alleviate as much pain and discomfort as possible from the dying process. For this, morphine is often a useful tool.

If you would like to speak with a hospice or palliative care specialist, the professionals from Tulsa’s Cura HPC are here to help.

Learn more about hospice and palliative care from Cura HPC today. 

What is a POLST Form & How Does It Differ From An Advance Directive?

Posted on Aug 02, 2019

what is a polst

Every day, people nearing the end of their lives receive unwanted medical treatment. Whether these are burdensome ICU stays, long-term feeding tubes, artificial ventilation, or even hospitalization at all, many receive the unwanted treatments that only delay the inevitable and making the dying process worse. Maybe they only wanted a treatment that would enable comfortable without extending their life. Maybe these people wanted to be able to pass away naturally at home. Because many cannot voice their preferences, the default action is for first responders and physicians to seek to extend their lives. If only they could easily inform these medical professionals of their treatment preferences...

Enter the POLST form.

“What is a POLST form?”

The acronym P-O-L-S-T stands for Physicians Orders For Life-Sustaining Treatment. This is typically a one-page, front-and-back form with checkmark-boxed questions that individuals use to tell first responders and physicians what kind of life-sustaining treatment they wish to receive in the event that they would require it to remain alive.

“How does a POLST form differ from an Advance Directive?”

The differences between a POLST form and an Advance Directive largely have to do with the logistical challenges posed by the needed speed of required treatment. In many instances, first responders have to quickly assess what kind of treatment someone wants. If the person is incapacitated, first responders and physicians may end up delivering treatment the person does not want. While an Advance Directive does convey what kind of treatment someone does or does not want (for example, ventilation, feeding tubes, or even simple CRP services), finding this information at a moment’s notice in an Advance Directive during an emergency situation can be difficult. Some Advance Directives are many pages long and may be written in complex legalese.

A POLST form, on the other hand, is typically one front-and-back form with around 10 treatment questions that are marked with checkboxes. At a glance, anyone can immediately know what kind of treatment the listed party wants and does not want. Many are instructed to leave it attached to their refrigerator in case first responders need to quickly reference it in an emergency situation. This makes the POLST form somewhat of an outline or “cliff notes” version of an Advance Directive when the information is quickly needed.

How does a POLST form differ from a Do Not Resuscitate (DNR) form?

Like an Advance Directive, a POLST form can work in concert with a DNR order. While a DNR order that can be displayed with a wrist band or other insignia and denotes not wishing to receive a CPR-related treatment, a POLST form provides additional details, such as the duration of life-saving treatment or hospitalization. A POLST is not a substitute for a DNR, but the two can work together to make sure the patient’s wishes are respected.

Who is a POLST intended for?

Unlike an Advance Directive that is a great idea to have no matter your age, a POLST form is especially recommended for people who may be in their last year of life or have any other form of an irreversible life-limiting condition. The POLST form is best suited to keep individuals from receiving unwanted treatments, making it not completely necessary for younger, healthy, able-bodied individuals.

With that being said, because of it’s succinct nature, a POLST form can be used as a tool to help those in the 50s, 60s, and 70s start seriously considering making their end-of-life wishes known to loved ones and physicians.

What if someone changes their POLST preferences?

If someone changes their end-of-life treatment preferences, the POLST form is completely amendable. It can be adjusted at any time. As long as they are able, one can make changes to their POLST form.

What is required for a POLST to be legally binding?

The only requirement for a POLST form to be legally binding is for it to be signed by the patient or a representative and the patient’s legal healthcare representative.

If you would like to download an Oklahoma POLST form, you can do so here . It is requested that it is printed on pink paper so as to increase its visibility.

If you would like a printed copy of the POLST form or would like to speak to someone about end-of-life care, look no further than the friendly people at Cura HPC Hospice & Palliative Care in Tulsa, OK.

Learn more about Cura-HPC Hospice & Palliative Care here.

Mourning Is No Time To Haggle

Posted on Aug 02, 2019

distressed and mourning man

Mortuary Services Can Be a Huge Expense

Many will end up spending more for funeral expenses for a loved one than they will for a car. Still, how many of us would feel that they were well suited to go car shopping immediately after a close loved one has passed away? Every decision would be filtered through grief and there’s little doubt that one’s judgment could be questioned. In the same way, waiting until the passing of a loved one to shop for final arrangements has a similar effect. People simply aren’t good at making the best money decisions when under major emotional distress.

Shopping After Passing Leaves One Wondering

Keeping in line with the car-buying analogy, how comfortable would you be buying a brand new car for a loved one who had never spoken a word about what they value in a car? You would simply have to think about their personality and essentially make a series of guesses. Do they like a sportier car or a luxury sedan? Would they prefer an environmentally-friendly electric car or would they actually be happier riding a bicycle? Any decision you’d make would still leave you to lie awake in bed at night, wondering if you had made the right the right decision. However, if they simply told you what you’d want, this would immediately streamline the entire process. This is what you can do for those you leave behind.

Your Choice Will Always Be Your Choice

One of the reasons people tend to purchase some of the highest-priced mortuary services and products are to “properly” honor their loved ones. If that loved one could see the itemized receipt for all of these products and services, they may not approve of such expense on their part — especially if the person paying had to go into debt in order to do so. However, one way to guarantee that one would approve of it is for the person to actually approve of it before they pass away — that person is you. When you make your own arrangements, not only are your loved one’s not essentially “car shopping in the dark” for you, but the expenses can even be negotiated. Yes, you can haggle for your own mortuary arrangements without appearing “cheap.” No one can argue with what you want or the budget of your final wishes.

To ensure you or your loved ones ability to pass on in as much comfort, grace, and dignity as possible, the hospice professionals from Cura HPC offer nurturing care. Feel free to reach out to us to discuss what options are available — either for the immediate or distant future.

Pizza, Friends, and...Death? Talking “Death Over Dinner”

Posted on Aug 02, 2019

Wine glass toast

Lack of Communication About Death

For being one of the most crucial things someone can discuss with loved ones, death is also a topic that few want to discuss. Because of this hesitancy, most people’s last wishes remain a mystery even to close family members. Some simply never take the time to even consider how they want to pass away or how they want to be remembered. In order to bring up the 800-pound gorilla in the room, a new initiative called “Death Over Dinner” has people talking — literally, that’s their goal.

Death Over Dinner

The Death Over Dinner initiative’s aim is to get people to discuss death in an open, relaxed environment — over a meal with friends, family, and whomever else. The program begins with a questionnaire on their website which decides what information is best for them to send the host of the dinner. The program contains conversation prompts, stories, videos, and other activities to keep the conversation flowing. It’s designed to be a balance of deep, yet lighthearted and educational.

The Point of Death Over Dinner

While the aim of the dinner is simply to help people feel more comfortable discussing death, a slight ulterior aim is to eventually help people make decisions about their own death and articulate them to loved ones. Aside from having to face their own mortality, these questions are much easier for a person to answer about their own wishes rather than having to make these wishes for others.

For those interested in hosting a Death Over Dinner at their house, simple visit the Death Over Dinner website and begin your questionnaire.

Making end-of-life care decisions can be difficult. In order to make end-of-life decisions easier to manage, Cura HPC is dedicated to providing professional and nurturing hospice and palliative care services. Contact us today for additional information.

The Conversation Project: A Conversation We Need To Have

Posted on Aug 02, 2019

While this reluctance is understandable, it creates an unintended and unnecessary outcome. Too many Americans die in ways they would have chosen because they are not making their preferences known to their loved ones while they are able. All too often, bewildered and confused family members and friends are forced to make these stressful decisions for them under duress. For this reason, Pulitzer Prize-winning journalist Ellen Goodman and her colleagues have started an initiative known as “The Conversation Project”.

One of the most important conversations we need to have is about death. Unsurprisingly, people would rather talk about something, almost anything, else than the reality of dying. People would even rather tell gossip-laden stories of heartbreak and dysfunction than the final destination for anyone who has ever lived. Still, too many people who are dying in ways they would not have chosen are not making their preferences for their own deaths known while they can. All too often, these loved ones become patients who cannot make their views known after it’s too late. It’s for this reason that Pulitzer Prize-winning journalist Ellen Goodman and others around her started an initiative known as the Conversation Project. 

The basic idea of The Conversation Project is simple: Conversations regard one’s death should happen at the kitchen table and not in the ICU. Having these important discussions at the right place and at the right time, provides people the opportunity to thoughtfully decide the kinds of care they do want, as well as do not want, to receive at life’s end. This gives both individuals and their loved ones help and peace of mind regarding the inevitable ending of life. 

The Conversation Project Materials

The main component of the Conversation Project is a questionnaire that can be downloaded from their website. The 12-page kit is available in many different languages to make navigating the questions as simple as possible. The kit is written to the loved one who initiates the end-of-life conversation. The materials not only cover what actions are to be taken but also about emotions going forward. The truest intention is to get all parties on the same page. 

Learn more about The Conservation Project here. 

For additional help navigating the sometimes confusing questions associated with end-of-life care, the nurturing professionals at Cura HPC Hospice & Palliative Care are more than happy to assist.

Learn more about Cura HPC, an Oklahoma-based Hospice & Palliative Care provider today. 

The Difference Between Palliative Care and Hospice Care

Posted on Aug 02, 2019

Ken’s grandfather, Loren, had been diagnosed with Parkinson’s disease many years prior, but his symptoms were becoming much more severe. Without being able to gain relief through the usual treatments, the family was nearly at a loss at what to do. One of the physicians associated with the senior living facility where Loren lived recommended that the family seek specialized palliative care for Loren. Upon hearing this recommendation, the family’s we surprised and their worry intensified. 

“Palliative care? Does that mean that his time with us is shorter than we thought?” 

“No, no,” the physician explained. “You’re probably thinking of hospice care — not palliative care. While Loren’s Parkinson’s is fairly severe, I don’t see him needing hospice care quite yet.” 

Loren’s family was justifiably confused. Due to a lack of clarity, they believed “palliative care” and “hospice care” to be synonyms. This mix-up led to an emotionally confusing situation. 

What is Hospice Care? 

While the definition of “hospice” stems from “hospitality”, the definition of the term in modern times means to care for as well as attempt to limit the suffering of the more immediately terminally ill. Hospice care has a unique protocol that is designed to not only comfort the dying but help families prepare themselves for the process of saying goodbye to a loved one. Hospice care is recommended when the end of life is more clearly in sight for medical professionals so the appropriate care can be provided. 

What is Palliative Care?

Unlike hospice care, palliative care is a special process of easing the symptoms of a disease or injury rather than seeking curative treatments. Many maladies that presently have no cure cause patients immense suffering and attempts to cure them may not be feasible or may even cause additional undue suffering. Some of these long term, yet not necessarily immediately terminal diseases may include certain varieties of kidney disease, liver disease, long-running cancers, AIDS, Parkinson’s Disease, ALS, and many others. While hospice may care may be necessary eventually, the approach of palliative care focuses on making the pain and discomfort more palatable in the meantime.  

In Summary

  • While they are sibling methods of care, palliative care, and hospice care are not the same thing. 
  • Hospice care is specialized to provide comfort to more immediately terminal patients and their families as the patient approaches their last days. 
  • Palliative care is specialized to alleviate as much of the discomfort of an ongoing ailment as possible when a cure is less likely. 

If you or a loved one are currently being recommended palliative care or hospice care, we invite you to learn more about the professional and nurturing Tulsa area hospice and palliative care services of Cura HPC. At Cura HPC, we care for your family the way we’d care for our own.

Learn more about Cura HPC.