Hospice of the Valleys serves hundreds of patients each and every year. We honor them by sharing their stores. They remind us every day of the meaning and purpose in our work and that human connection is at the heart of the hospice experience.
The following are notes Hospice of the Valleys has received from the families of patients that we have been privileged to provide hospice care.
"To all who served on my grandma's care team, Thank you for the care you provided. Your assistance with her care was priceless and I could not have cared for her without you."
PPSD - Post Pandemic Stress Disorder
By: Dr. Leslee B. Cochrane Executive Medical Director
It has now been just over two years since the Covid-19 Pandemic began in California. Although as current indicators are trending in a favorable direction, we are now beginning to look back and survey the toll that the last two years have taken on our society. As we begin to see various Covid restrictions lifted and our lives begin to return to normal there is a great sense of relief; but much like the aftermath of a hurricane, the pandemic has left a wake of destruction in its path.
According to the most recent estimates, there have been over 79 million documented cases of Covid-19 in the United States and over 950,000 deaths. When people survive through traumatic events like combat, accidents or physical assault some of them experience a condition known as post-traumatic stress disorder, or PTSD for short. Although the pandemic has not been as intense for most as the events leading to PTSD, it is undeniable that there has been significant impact caused by the stress of the pandemic.
Even those who have not been seriously ill due to Covid have experienced altered daily routines, financial pressures, social isolation and increased uncertainty. Add to this the endless media reports about the pandemic and it is no wonder that surveys have shown a major increase in the number of U.S. adults who report increased stress, anxiety, depression and insomnia during the pandemic. Although we cannot control the pandemic, we can control how we respond to the stress in ways that decrease the negative impact.
As we transition from the pandemic response to a pandemic recovery, it is time to attend to the mental and emotional impact caused by the pandemic. Below are several helpful suggestions from the CDC on how to deal with the stress related to the pandemic:
Take breaks from watching, reading, or listening to news stories, including those on social media. It's good to be informed, but hearing about the pandemic constantly can be upsetting. Consider limiting news to just a couple times a day and disconnecting from phone, TV, and computer screens for a while.
Take care of your body - Take deep breaths, stretch, or meditate. Also, helpful is take preventative measures, eat healthfully, exercise and get plenty of sleep.
Make time to unwind - take time for yourself and also connect with others.
For more information on coping with stress during the pandemic, I would refer you to the full article where the above recommendations were found at https://www.cdc.gov/mentalhealth/stress-coping/cope-with-stress/index.html
Hospice of the Valleys serves hundreds of patients each and every year. We honor them by sharing their stores. They remind us every day of the meaning and purpose in our work and that human connection is at the heart of the hospice experience.
The following are notes Hospice of the Valleys has received from the families of patients that we have been privileged to provide hospice care.
"Thank you for the respect, kindness and honor you showed our father. Please accept this gift with gratitude. What you do means so much to so many people. So once again thank you."
Caring for the Caregivers
By: Dr. Leslee B. Cochrane Executive Medical Director
According to the Family Caregiver Alliance, about 34.2 million Americans have provided unpaid care to an adult age 50 or older in the last 12 months. In most cases, these caregivers were a spouse, partner of family member who provided care to a frail elderly person who required assistance with activities of daily living and medical tasks. Although they do not receive a salary, the estimated value of services provided by informal caregivers has steadily increased over the last decade, with an estimated economic value of well over $470 billion.
Being a caregiver is quite challenging under normal circumstances as many caregivers feel guilty if they spend any time on themselves rather than focusing on the needs of their loved ones. During the Covid-19 pandemic, the need for prolonged periods of isolation and the constant fear of their loved ones contracting the virus has greatly increased the stress on caregivers. These dynamics have placed caregivers at high risk of burnout, which is a state of physical, emotional and mental exhaustion.
This extra workload acts as a "stress-test" on the caregiver and in order to avoid burnout, caregivers need to have a plan. Caregivers are often so busy caring for the needs of others, that they frequently neglects themselves. To endure the additional stress of caregiving during the pandemic and avoid burnout, it is necessary for caregivers to regularly practice selfcare. Below are several recommendations from the CDC[i] listing steps that caregivers can take to deal with the increased stress associated with the Covid-19 Pandemic:
Eat a healthy diet, avoid using drugs and alcohol, and get plenty of sleep and regular exercise to help reduce stress and anxiety. Activities as simple as taking a walk, stretching, and deep breathing can help relieve stress.
Establish and maintain a routine. Try to eat meals at regular times, and put yourself on a sleep schedule to ensure you get enough rest. Include a positive or fun activity in your schedule that you can look forward to each day or week. If possible, schedule exercise into your daily routine.
Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting. If you want to stay up-to-date on the pandemic, visit CDC's website for the latest recommendation on what you can do to protect yourself and those you care for.
Make time to unwind. Try to do activities you enjoy.
Connect with others. Reach out to family and friends. Talking to someone, you trust about your concerns and feelings can help.
Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.
Have a backup caregiver. In case you become sick with COVID-19, a backup caregiver will ensure that your loved one continues to receive care. You can focus on caring for yourself.
Healthcare workers and first responders have been hailed as "heroes" during the Covid pandemic; but I would like to recognize the true unsung heroes of the pandemic - the caregivers who have been providing the day-to-day care for the disabled and the frail elderly! If you know if someone who is serving as a caregiver, please take a few moments to give them a call or send them a letter of thanks in recognition of the amazing work they are doing.
The Life of a Tree
By: Dr. Lynn Euzenas Director of Spiritual Care & Bereavement Services
Last weekend I watched a most remarkable nature film, "Borealis." In extraordinarily beautiful images, it tells the story of the Northern Canadian forest unveils the life of a tree. Did you know that the trees of different species connect feelers with other trees so that the forest will survive? Or that individual cells in leaves actually breathe? That trees produce more seeds when another species needs them for food? Or that the seed cones of some trees can only be unlocked to reproduce through the destroying heat of a wildfire?
I was stunned by the coursing of life through the trees and how the forest itself is created by the extension of each to the other. I was struck by how dependent one is upon the others, for life, oxygen, beauty, and as a sheltering habitat for many other species. Most stunningly, I was astonished at how deeply life is both sustained and imprinted upon these magnificent beings. And I was captured by thoughts of how human loving could learn and grow from these lessons.
Love is our very life source. It is the thing which allows us to breathe and grow and sustains and steels us against adversity. It teaches us again and again how vital we are to each other. We cannot live and thrive without love. Love is our life force which acknowledges that we are not meant to be isolated or alone: as we give love, we receive love. Love is that power which allows us to be a sheltering habitat for others, to share sustaining breath, and to recognize how interconnected we all truly are. For as the forest teaches the diversity of the wood is essential for its survival: at is very roots. Love too carries that lesson to us. If understood as that force which connects us all and gives us true life and breath, we can come to understand that there are the seeds which do come to fruition only when heated under the fires of adversity: the is the power of Love.
Life's most profound lessons are often revealed in the wonders of nature. Look to the trees and ponder their beauty. Look into your heart, and ponder the roots and nature of Love.
Hospice of the Valleys serves hundreds of patients each and every year. We honor them by sharing their stores. They remind us every day of the meaning and purpose in our work and that human connection is at the heart of the hospice experience.
The following are notes Hospice of the Valleys has received from the families of patients that we have been privileged to provide hospice care.
We were so very touched to receive a beautiful call last week from a family's loved one who passed on Hospice of the Valleys' service. They could not say enough about the wonderful care they received and the excellent direction they received from the assigned team as well as the amazing triage nurses and after hours nurses. "I couldn't have done this without you all."
Wishing Upon A Star
By: Dr. Lynn Euzenas Director of Spiritual Care & Bereavement Services
As we kick off the new year, I remember listening to a holiday album, and there I was surprised by a wonderful duet by Mary J. Blige and Barbara Streisand, singing "When you Wish Upon A Star." That song destined for magic from its composition. Leigh Harline and Ned Washington wrote it in autumn of 1938 for the story crew of the fledling Disney to-be-classic Pinocchio. When they played it for the staff, it was immediately embarased as the theme song for the cartoon feature length movie. The actor whose voice was cast as Jiminy Cricket, Cliff Edwards, recorded the song, and it elevated Jiminy's role in the move from a minor one to that of the narrator, and the song was elevated to the movie theme playing over the opening credits. Subsequently, it became the familiar theme of all things Disney.
And I thought to myself, what better a song do we need for 2022?
When you wish upon a star
Makes no difference who you are
Anything your heart desires
Will come to you
If your heart is in your dream
No requested is too extreme
When you wish upon a star
As dreamers do
Fate is kind
She brings to those who love
The sweet fulfillment of
Their secret longing
Like a bolt out of the blue
Fate steps in and sees you through
When you wish upon a star
Your dreams come true
As we step out of 2021 into a new year, so many still feel the weight of the continuing pandemic, the heaviness of the clothing of griefs of many kinds, the struggle to find our footing amidst the cycles of changes to what had been "normal" to us. There is a tiredness which lingers in this "old year" which we'd like to shed in the "new."
So is it too simplistic to call us to dream again? To make a wish and believe? To trust that, contrary to what we've been experiencing, that "fate is kind, and she brings to those who love the sweet fulfillment of their secret longing>"
On New Year's Eve, I stood outside and looked up, made a wish that all of our dreams come true.
Peace and joy, good health and happiness, and a restoration of the child in all of our hearts is my wish for all of you, in the New Year, 2022.
Caring for Our Community in Times of Uncertainty
By: Dr. Leslee B. Cochrane Executive Medical Director
During the holidays I took my family to the Hotel Del Coronado on a surprise visit with friends to see the incredible holiday light show. We enjoyed strolling through the beautifully decorated Hotel and grounds including an outdoor ice skating rink. The evening was topped off with hot coffee drinks and delicious gelato. Our family made some wonderful memories that will last a lifetime.
Unfortunately, not all "surprises" are good ones, like when a loved one finds out that they have a serious medical condition with only months to live. We at Hospice of the Valleys have been providing exceptional end of life care to hospice patients and their families for nearly 40 years. During the Covid pandemic, our incredible hospice team has provided uninterrupted hospice care to our community 24/7. Because we are your local non-profit community hospice, our mission has always been and will always be focused on taking care of our community. As Hospice of the Valleys, we care for our patients and their families with the same compassion and excellence we would want for our own family.
Despite the ongoing Covid-19 pandemic, Hospice of the Valleys was the only Hospice Program in the entire State of California to achieve Hospice Honors Elite status in 2021. This recognition is issued by the Health Care First organization based on exceeding the National Standards on each of 24 separate quality indicators measured in the Medicare family satisfaction with hospice survey. Thanks to the generous support of our community, we are able to provide excellent end of life care to those in need of care and no one is ever turned away due to a lack of insurance or resources.
During this time of increased uncertainty created by the Covid pandemic, we want you to be assured that Hospice of the Valleys will continue to provide exceptional end of life care to all who need it. Medicare patients, not their insurance or doctors, have the right to choose which hospice they feel will provide the best care. This is true, regardless of what type of Medicare plan they have. If you or someone you know is in need of end of life care and you are looking for a hospice that was rated as "elite" by the families we serve; please give us a call at 951-200-7800. If you have questions or concerns about hospice care, we would love to talk to you. Caring for our community is what we do best!
Hospice of the Valleys serves hundreds of patients each and every year. We honor them by sharing their stores. They remind us every day of the meaning and purpose in our work and that human connection is at the heart of the hospice experience.
The following are notes Hospice of the Valleys has received from the families of patients that we have been privileged to provide hospice care.
"Thank you to the entire staff at Hospice of the Valleys! It was so comforting to know you were there during the last part of life and easing into the passing of my dear father. You are a wonderful organization and very caring and compassionate."
"I'm sorry this has taken so long in coming. On behalf of the family I want to tell you and your staff and doctor and caregivers how much your work meant to us. We are grateful for your caring kindness. Thanks for the follow up for our well-being."
What is New about the Flu (shot)
By: Dr. Leslee B. Cochrane Executive Medical Director
Did you know that there are many different types of flu shots available each year to choose from? According to the CDC, everyone 6 months of age and older should get a flu vaccine every season, with rare exceptions for those with certain medical conditions or who may have allergies to vaccine ingredients. For the 2021-2022 flu season, there are both injectable (shots vaccines as well as a nasal spray available. Different influenza vaccines are approved for different age groups with some vaccines specially designed for those over age 65 who are at highest risk of complications to the flu.
Each year the flu season begins around October and then peaks between December and February and the sooner you get your shot the better. Because flu strains are different from year to year, it is necessary to formulate a new flu shot for each flu season. The annual flu shot for 2021-2022 is called a "quadrivalent" shot because it actually contain vaccines against the four most prominent strains of the season flu. I have included a list of the various flu vaccines available for the 2021-2022 flu season below and encourage you to discuss this information with your health care provider to determine if you should take a flu shot, and if so, which shot is right for you.
Standard Flu Shots- Standard-dose quadrivalent flu shots including Afluria Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, and Fluzone Quadrivalent. These vaccines are manufactured using virus grown in eggs, so those allergic to egg protein cannot use them. Each of these standard dose quadrivalent shots are licensed for different age groups.
Flucelvax Quadrivalent is an egg-free vaccine alternative licensed for people ages 4 and older who are allergic to eggs and Flubiok Quadrivalent, is another egg-free vaccine, approved for people 18 years and older.
Enhanced Flu Shots for those over age 65- Fluad Quadrivalent is a quadrivalent flu shot using an added ingredient which helps to boost a stronger immune response and is approved for people over age 65.
Fluzone High-Dose, is a specially formulated quadrivalent flu shot containing a higher dose of the antigen to help create a stronger immune response and is licensed for people over the age of 65.
Nasal Spray Flu Vaccine- For those of you who do not like needles, FluMist is a quadrivalent vaccine, which is given intranasally. This vaccine is approved for people 2 through 49 years of age. Please note that live attenuated influenza vaccine should not be given to people who are pregnant, immunocompromised persons, and some other groups.
Can I take a flu shot and a Covid shot at the same time? As with all the health care decisions, I recommend you discuss the option of vaccinations with your health care provider to see what is best for you. If you decide to take a Covid-19 shot or booster when you make an appointment for a flu shot, according to the CDC, Covid-19 vaccines may be taken on the same day as a flu shot.
Happy Holidays
By: Dr. Lynn Euzenas Director of Spiritual Care & Bereavement Services
The holiday season dawns brightly this month, already aglow with twinkling colored lights and family holiday displays delighting our neighborhoods. There is something about this time of year which draws us to Light. Those who celebrate the festival of Light, Hanukkah, often know this time as "The Season of Light." Those who celebrate the birth of Jesus cannot but help call upon him as "the Light of the World." Ancient pagan religious sought Light to signify the rebirth of the sun during winter. We buy gifts for those who are "The Light of Our Lives," and use the image of a single, lit candle, piercing the darkness as a sign of hope in diffuse times. Our Hospice of the Valleys' fall memorial is a celebration of Light as we invite families to light a luminaria in memory of a dear one whose memory will always burn brightly.
So I send to you a simple greeting this newsletter. An invitation, actually. Find some quiet time for yourself. Slow the hustle and bustle down, and pull up a comfortable chair, and sit in the darkness by yourself for a few moments. Feel its velvet edges stir in you all that the darkness is capable of doing: calmness, anxiety, loneliness, uneasiness, beauty, and even fear might arise. Just notice the feelings and let them be like passing clouds across a bright, blue sky: just observe them, but don't engage them.
Into the darkness, light a single candle you have brought with you into the room. It doesn't have to be a wax candle that you need a match to light, it can be a candle from a holiday decoration which is battery operated. Just sit with that single point of light. What do you see? How does it make you feel? What happened to the feelings which arose during the time of the darkness What does it call you to remember? Enjoy these moments.
Just take the time, you, and your candle, to see how that point of Light can change everything. Receive the gift of Light you have provided yourself for this moment of beauty and hope.
May you have beautiful holiday times that rejuvenate your soul, fill you with love and laughter and joy, and remind you of how simple it can be to find a point of beauty in the darkness.
Hospice of the Valleys serves hundreds of patients each and every year. We honor them by sharing their stores. They remind us every day of the meaning and purpose in our work and that human connection is at the heart of the hospice experience.
The following are notes Hospice of the Valleys has received from the families of patients that we have been privileged to provide hospice care.
"My family and I would like to say thank you for the care you provided. That care was felt by our entire family."
"Thank you to all the hospice workers and volunteers who helped me through the last days of my husband's life. Your kindness and caring will forever be remembered."
Covid-19 Update and Treatment Options
By: Dr. Leslee B. Cochrane Executive Medical Director
Because of the rapidly changing nature of the Covid-19 pandemic, many people are left wondering what treatments are currently available. Below is an update on the status of Covid-19 in Riverside County along with a summary of various treatment options currently available.
Vaccination Status - Riverside County has made excellent progress regarding vaccination. To date approximately 2,982,726 doses of Covid vaccine have been administered and over 70% of those over age, 65 are now fully vaccinated. Overall, 58% of all Riverside County Residents have received at least one dose of vaccine and approximately 51% of all residents are fully vaccinated.
Vaccination Boosters - the CDC now recommends that certain people receive booster shots of the various COvid-19 vaccines including the Pfizer, Moderna, Johnson and Johnson vaccine after 6 months. The following groups listed below are eligible to receive boosters and the FDA has recently approved the option to mix and match the various vaccines. As always, please consult with your physician to see if taking a booster dose is right for you.
65 years and older
Age 18+ who live in long-term care settings
Age 18+ who have underlying medical issues
Age 18+ who live in high risk settings
Age 18+ who work in high risk settings
Covid-19 Cases - Covid-19 cases have been steadily declining in Riverside County for the past eight weeks, current hospitalization, and ICU cases have steadily been dropping since mid-August as well.
Covid-19 Deaths -Â Since the peek of the pandemic in January of 2021, Covid 19 deaths in Riverside County have been trending downward. The Riverside County death rate has dropped for the fifth consecutive week and remains very low.
Covid-19 Treatments -Â The best time to discuss treatment options for Covid-19 with your healthcare provider is before your become infected. If you feel you may have Covid-19 or have been exposed to someone who is infected contact your healthcare provider immediately. Although vaccinations have played a significant role in reducing the number of Covid-19 infections, no vaccine is 100% effective and we are now seeing reports of fully vaccinated patients who still develop Covid-19.
Many patients who become infected with Covid-19 will have only mild to moderate flu-like symptoms lasting 1-2 weeks and will not require hospitalization. The overall recovery rate for Covid-19 is between 97% to 99.75%.
The most likely to become seriously ill and require hospitalization are those over the age of 65 the those with pre-existing medical conditions. For those patients who are at higher risk for complications, there are several FDA approved treatments available at this time. These treatments have received emergency Use Authorization (EUA) and they have been shown to reduce the risk of serious complications. Each of the current treatment options described below require prompt consultation with a physician and several require hospitalization.
Monoclonal Antibodies The FDA has issued and EUA for outpatient treatment with monoclonal antibodies for patients who test positive for Covid-19 and are at high risk of complications. These medications can be given via an infusion in an outpatient testing and are most effective if given early in the course of infection. To find our if you are a candidate for monoclonal antibody treatments, I recommend that you discuss this option with your healthcare provider before you are infected. To learn more about the availability of Monoclonal antibody therapy in Riverside County please see the following link to a recent article about a new Riverside County Treatment Center providing this therapy: https://patch.com/california/temecula/new-covid-19-treatment-center-opens-riverside-county.
FDA Approved Treatments There are currently 11 treatments with FDA Emergency Use Authorization including treatments such as convalescent plasma, Remdesivir and Baricitinib but these treatments are reserved for hospitalized patients only. Many clinical trials are currently underway to investigate other potential treatments.
Other Treatments There are numerous other medications such as dexamethasone and ivermectin, which have been used for decades to treat other medical conditions and are now being used by some physicians to treat Covid-19. Some of these treatments have shown potential benefits in a limited clinical studies but the results are inconclusive and the current FDA position on ivermectin is that there is insufficient evidence to recommend for or against the use of ivermectin for the treatment of Covid-19. You should discuss any questions you have about these treatments with your physicians.
In closing, most patients who become infected with Covid-19 will not require hospitalization and can be expected to fully recover. If you are over 65 or in a high-risk group for complications related to Covid-19 infection, I encourage you to consult with your physician in advance to determine which of the available treatment options would be best for you. Of course, please contact your physician immediately if you develop any signs or symptoms of Covid-19.
Coping with the Holidays
By: Dr. Lynn Euzenas Director of Spiritual Care & Bereavement Services
Dear Friends:
I come to this writing feeling a restless wistfulness. The world looks and feels so very different these days as we come into the holiday season. Many have shared with me that they are really feeling the changes which the pandemic has wrought. There's a palpable lack of civility in public spaces and an increase in impatience and rudeness. We've become more demanding and less forgiving and more in a hurry. The changes we've all felt at work, in play, school and office, (and even family), have unsettled us and we're trying to discover how to stay upright. One can imagine the giant hand of The Pandemic flipping open a Pandora's box, then violently shaking that old familiar box of things we've called "home". Those familiar moorings have been torn loose and things just haven't seemed to feel right. Plainly, things seem "all out of whack."
A word or two of encouragement for these times. We're all just tired. We have kept one foot in front of the other for the past year and a half and haven't really taken stock of the many and varied changes we are living through. The good news is that we haven't lost ourselves, or willingly given ourselves over to unkindness, impatience, and craziness. We've just delayed so much grieving: so many souls lost to the pandemic; big and little changes in the familiar handholds of routines of life (in our jobs, our families, in the day to day); the feeling that those familiar things which grounded and comforted and shaped us have been altered; and looking ahead to another holiday season with uncertainty about traveling and COVID and family plans. Many of us have lost loved ones during the pandemic, or have dear ones who are grieving a loss. Coping with the holidays this year is certainly a different prospect. Taking time to care for yourself, asking for help when it is needed, and coming into this season contented with who you are right now, will all get your holidays started on the right foot.
The bereavement department at Hospice of the Valleys traditionally offer a variety of programs for Coping with the Holidays. This year is no different. If you would like more information about these programs, please call the Bereavement Department at Hospice of the Valleys at 951-200-7800. Talk to one of our bereavement counselors. Let us send you some simple yet effective ideas for taking some of the stress out of your holidays. Let us know if you would be interested in attending a program on Coping With the Holidays. We would be glad to assist you.
The best medicine for entering into these wonderful yet challenging holiday times is really simple, and twofold: be grateful for the many blessings which shape your life, and take the time out to care for yourself, finding the support you need to relax and enjoy.
By: Dr. Lynn Euzenas Director of Spiritual Care & Bereavement Services
We are pleased to celebrate Spiritual Care Week for 2021 from October 24th through October 30th. Our spiritual care providers/chaplains are an integral part of the hospice team, working alongside our physicians, nurses, social workers, health aides, and volunteers to provide loving end-of life care which of attends to the body, mind, and spirit. Hospice spiritual care providers are specially trained to provide culturally sensitive care to people of many different religious and spiritual traditions. Each hospice family can choose whether or not they would like to include the spiritual care provider on their team. We are neither exclusively "religious" or exclusively "non-religious." Hospice spiritual care providers see themselves as providers of non-sectarian care for each person, in a way that honors and cherishes their own, individual and unique spirit.
Christina Pulchalski defines spirituality as that "aspect of humanity that refers to the way individual seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to be the significant or sacred." We affirm that each individual thrives in circles of meaning and purpose in their lives which help to grant them a unique perspective on the living of life in its fullest scope: from its person is often the brightest and strongest resilience one can draw upon for strength and courage for the journey at the end of life. That journey, which poses at its offset deep questions of meaning, fears of the unknown and of suffering, often transforms into a place of great depth of understanding, love, and profound peace, when shared. Your HOV spiritual care providers consider it an honor and a privilege to be able to walk the spiritual journey with our patients and families.
So, what do spiritual care providers/chaplains do with our patient and families to meet such lofty goals? We listen and laugh, we educate and guide, we play cribbage and watch television together, we encourage the telling of life stories, we read and watch and pray...we cry, and share, we sing and play music, and marvel at the richness of life. All the while affirming the wholeness of a person: body, mind, and spirit.
So in October, reach out to your spiritual care provider. Send a text or an email of appreciation. Share a kind word. Send along a prayer. Consider how your life may have been made better by knowing a chaplain.
Hospice of the Valleys serves hundreds of patients each and every year. We honor them by sharing their stores. They remind us every day of the meaning and purpose in our work and that human connection is at the heart of the hospice experience.
The following are notes Hospice of the Valleys has received from the families of patients that we have been privileged to provide hospice care.
"Dear staff of Hospice of the Valleys, We are extremely grateful to the entire team that took care of our much loved sister. We appreciate all the help and support you have given us. We could not have done the necessary care that she needed without your team."
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"Thank you all for your support - physical and emotional. I have learned a lot from you and have appreciated your kindness."
Hospice of the Valley's Mission
By: Dr. Lynn Euzenas Director of Spiritual Care & Bereavement Services
Dear Friends:
On the Hospice of the Valleys webpage you will find our mission statement:
We foster reverence for life, relief of suffering, and compassion in loss for the terminally ill residents and their families in the communities we serve.
I've grown a bit reflective in my eighteenth year working at Hospice of the Valleys. I remember years ago a team of us sitting around the table exchanging thoughts and sharing stories and working diligently to find just the right words to express what we deeply believed was the heart of the hospice work to which we'd dedicated our lives. Today, these words stand as solidly for me as they did then.
Eighteen years is a lifetime when you consider the rapidly changing environment of state and federal regulations which shape healthcare/hospice care and the normal changes over time in personnel and leadership teams, let alone the appearance of an unprecedented pandemic. If it is a good one, the mission statement of an organization will hold it fast during the storms which can come in nearly forty years of service to our community. Our mission statement is a testament to the fact. It is what we do, it is who we are, it is how we serve... how we love. Indeed, each of us carries a copy of it attached to our name badges each day. We all know to abandon it would be to our peril.
What does it mean for this hospice worker? We foster reverence for life:Â Choice of words is important here. To foster something is to encourage or promote its development...to nourish or feed it. While the word reverence means to hold something in deep respect, its roots from the Old French and Latin give a deeper nuance which is so important here: to reverence means to stand in awe of something. So, to foster reverence for life is to marvel in the miracle of life, and to support and encourage each one in our care to embrace the preciousness of their own life in all of its uniqueness and beauty. One afternoon I heard a sharp crack at my glass door and found on the ground a tiny, what appeared to be broken hummingbird. I knelt and gently picked up the tiny, inert body, and cradled it in the palm of my hand. I wept that such a wondrous and beautiful creature was now still. In what seemed almost just a moment, I was startled by a flurry of motion which suddenly found my hands empty. The bird had just been stunned and was fine. For a few brief seconds, she had stopped to remind me of the reverence for all life.
...relief of suffering... Anyone who has ever been in pain, or been with someone who is in pain, knows the desperation of desire to be freed from that pain. The essential action and intention of hospice care is the relief of suffering: be that from physical, emotional, and /or spiritual pain and distress. There is no more humbling and deeply human experience than watching and hearing and feeling with another the relief of one whose pain has been eased or even lifted. The gift of life returns to them, and light and peace and rest floods into view...blessed relief. We aspire to work towards the relief of suffering in each individual.
...compassion in loss... Hospice acknowledges the sacred duty of extending reverence for a life and relief of suffering to those who must walk the path of loss. Loss is an undeniable companion on a life of love's journeying. To have compassion for someone, quite literally, means to suffer with them. As we empathize with another, we can never fully know what they are feeling. With the outreach of compassion we offer the gift of presence: of simply being with another and feeling in our hearts what it would be like for us to experience what they are now feeling. Hearts reaching out in a caring embrace: the plaintive offering which says, "If I could beat this for you, my friend, I would."
This is more than a mission statement, it is a credo. It is what we call the heart of hospice. It is why we exist in our community. It is the Hospice of the Valleys difference.
You Are What You Consume
By: Dr. Leslee B. Cochrane Executive Medical Director
Happiness is an emotion that is directly related to how our brains function. Research shows that when people try to achieve happiness through the pursuit of material possessions, they typically experience increased levels of stress and anxiety, which inhibit healthy brain function. They may also experience additional negative emotions such as envy, resentment and loneliness that further inhibit healthy brain function. On the other hand, once people finally get what they want, they begin to experience fear (another happiness killer) that they will lose it. One of the leading experts in the field of brain function and happiness is Dr. Amit Sood who is the Executive Director for the Global Center for Resiliency and Wellbeing and a former Professor of Medicine and Chair for Student Life and Wellness at the Mayo Clinic. Dr. Soo has authored or co-authored over 70 peer-reviewed papers and several books on various topics including happiness and resiliency. Dr. Sood and his associates have conducted extensive research over two decades relating to happiness, which has shown that there are several basic principles involved in how to become happier, stronger and kinder.
A key concept shown by Dr. Sood's research is that developing a better understanding of the connection between brain function and happiness is essential. The best way to achieve authentic and sustained happiness is to understand that happiness is one of the goals of your personal journey; but not the destination. By understanding how our brains work, we can avoid doing things, which work against happiness and strive to develop healthy brain habits such as gratitude, mindfulness and kindness that have demonstrated a strong correlation with increased levels of happiness and resiliency.
Extensive research has shown that the human brain is not able to experience happiness when negative emotions such as stress, fear, anxiety, resentment and loneliness are present. Research has also shown that in order to achieve sustained authentic happiness one must intentionally pursue deep and meaningful relationships, develop meaningful life pursuits and learn how to savor and share their passions with others. Managing negative emotions, which prevent happiness, is a life skill that anyone can learn according to Dr. Sood. To learn more about how to achieve greater happiness and develop healthy brain habits around gratitude, kindness and mindfulness I would encourage you to visit Dr. Sood's website at https://www.resilientoption.com/
Hospice of the Valleys serves hundreds of patients each and every year. We honor them by sharing their stores. They remind us every day of the meaning and purpose in our work and that human connection is at the heart of the hospice experience.
The following are notes Hospice of the Valleys has received from the families of patients that we have been privileged to provide hospice care.
"Words alone can't thank you enough for the precious care my husband received from your organization. You are truly angels"
"Thank you for your compassion and caring manner your staff showed. Everyone was so great and we felt at ease in your care."
You Are What You Consume
By: Dr. Leslee B. Cochrane Executive Medical Director
We all know that it is important to eat a balanced diet and to avoid excessive consumption of junk food because it is bad for our health. In the same, that good nutritional intake is essential to good physical health, it is important to realize that what we "consume" in the form of social media including television and radio can have an important impact on our mental and emotional health.
Although the widespread availability of Covid-19 vaccinations has dramatically decreased the risk of hospitalization or death due to COvid-19, there remains significant lingering anxiety related to the pandemic. IN a recent national poll conducted by the American Psychiatric Association earlier this year, 41% of those surveyed reported that they are more anxious about Covid-19 than they were a year ago. The age group most likely to be anxious were young adults aged 18-29 (49%) while only 40% of those over age 65 reported feeling more anxious this year than last year.
According to CDC statistics, those aged 65-75 were 6 times more likely to be hospitalized and 95 times more likely to die due to complications of Covid-19 than those aged 18-29. While it is entirely reasonable for people to feel an increased level of anxiety due to Covid-19, one would think that given the 95 times greater risk of death, that those aged over 65 would be more anxious when compared to those aged 18-29; yet what we see is quite the opposite.
Although the survey did not reach any conclusions regarding the cause of this discrepancy, it remains clear that the anxiety among younger adults seems to be out of proportion to their actual risk of hospitalization or death. There may be a variety of factors, which have influenced this finding; but one factor worth considering is the increased "consumption" of social media by younger adults when compared to those over 65. According to a recent Pew Research Poll, 84% of adults age 18-29 use at least one social media platform daily as compared to only 45% of those over 65.
The growth of social media over the past two decades has seen the number of people using Facebook increase from 65 million users in 2005, to over 2.7 billion creased consumption of social media and increased risks of mental health issues such as anxiety and depression. Many healthcare workers are now sounding the alarm regarding the dangers of too much social media and some now consider it a public health crisis.[i]
One of the most devastating aspects of the pandemic has been social isolation, which has resulted from the need to quarantine those at a high risk. At times, this has meant that patients have died alone, separated from their loved ones. I think this has caused all of us to realize that there is a big difference between a virtual hug and a real one. Humans are social creatures and being connected with others is an essential to our emotional and mental well-being. If you are feeling anxious, consider un-plugging from your electronic devices and re-connecting with your friends and family in person.
If you or someone you know has lost a loved one during the Covid-19 pandemic please know that Hospice of the Valleys provides no-cost community grief and support groups even if your loved one was not under our care. If you would like more information about our bereavement support services, please check us out on the web at www.hospiceofthevalleys.org or feel free to contact our bereavement department during regular office hours M-F at 951-200-7800 and a member of our bereavement team will be happy to assist you in finding the most appropriate type of support for you.
12 Ways You Could be Like an Olympian:
By: Dr. Lynn Euzenas Director of Spiritual Care & Bereavement Services
12 Ways You Could Be Like An Olympian:
Every four years or so, when the Olympics are back, I marvel at the amazing displays of individual fortitude, strength and courage, and the indomitable team spirit displayed for the world's eyes to see. So few of us will ever achieve such a highly focused level of physical and mental achievement, pristine physical fitness, or sheer determination and dedication. As I sat here on my couch, applying Icy Hot to my knee, I could easily count (with large doses of self-deprecation) at least 27 ways I am not, nor ever will be, an Olympian.
In 2002, Daniel Gold and his colleagues did a study of 10 US Olympians and were able to identify 12 core psychological characteristics shared by all Olympians. Perhaps this will help you answer the questions: "In which ways could I be more like an Olympian?" Here are his Twelve Core psychological Characteristics of Olympians:
The ability to cope with and control anxiety
Confidence
Mental toughness
Sports intelligence
The ability to focus and block out distractions
Competitiveness
Having a hard-work ethic
The ability to set and achieve goals
Coachability
Hopefulness
Optimism
Perfectionism
How do you measure up? I love using this list of attributes to consider that someone might very well get a gold medal in hopefulness, or a silver in optimism!
Or how about a team bronze in the ability to set and achieve goals? What a wonderful world!
Hospice of the Valleys serves hundreds of patients each and every year. We honor them by sharing their stories. They remind us every day of the meaning and purpose in our work and that human connection is at the heart of the hospice experience.
The following are notes Hospice of the Valleys has received from the families of patients that we have been privileged to provide hospice care.
"Thank you for your unselfish dedication of time and care. We appreciate the prayers, constant communication and care. You are truly a God-send."
The Hospice Promise of Relief from Pain
By: Dr. Lynn Euzenas Director of Spiritual Care & Bereavement Services
Early in my hospice career, I went on an admission visit with the hospice physician to the beside of a young woman with an aggressive cancer. The physician asked her, "What goals do you have for your treatment? What can we do for you?" She turned and looked up at us and told us her story.
"I have been from hospital to hospital, specialist to specialist, clinic to clinic, and for almost 6 years now, no one... no one... has been able to get me relief from this pain." In desperation she said to us, "Please, will you be the ones to finally help? And... would you pray with me>"
The physician's answer was a gentle one. "If you can give us a few days, I promise you that we can and will improve your pain and help you to be more comfortable." He smiled at her, and said, "Yes of course we will pray for you." She seemed surprised when he got down on one knee, and led the patient and the chaplain in prayer for her. Following the prayer , and in tears, she told us that this was the first moment in a very long time that she had felt any hope whatsoever.
It wasn't in two or three days, but within a few hours, that through the expertise of a hospice physician, and a caring hospice team, she reported relief from her intractable pain.
This i one of the great miracles of the promise of hospice care: that with the appropriate time, care, and skill, a patient's goals to be comfortable and not debilitated by pain are obtainable and very real. For the patient in pain, that can mean a restoration of life. Pain is a harsh master: it can immobilize you, rob you of sleep, override the ability to think clearly, and very simply limit the scope of your existence of the world of pain vs. the world without pain. Pain rules, and co-opts, any available energy a person may muster for the things that make us truly human: the ability to communicate clearly to love, to laugh, to have dreams and visions, and to be fully ourselves with families, in short, to live. The alleviation of pain restores these vital, life giving, human attributes.
As a person new to struggling with chronic pain, experiencing its real presence and its power, I re-affirm in a truly visceral way my belief that one of the greatest gifts hospice care can give a patient and family is indeed the alleviation of pain and the restoration of comfort at the end of life. It is truly, truly life giving.
By an ambassador for hospice care in our community: remember the story of this all too young woman patient, who found a new life at a critical time, due to the miracles and blessings of hospice care.
Catch some Fun in the Sun to Boost your Vitamin D Levels
By: Dr. Leslee B. Cochrane Executive Medical Director
The Covid pandemic has increased our awareness of the importance of a healthy immune system and Vitamin D has long been recognized as an essential component to a healthy immune system. Although there are conflicting reports as to whether or not taking Vitamin D supplements can prevent or treat Covid-19 infections, it has been well documented that Vitamin D deficiency has been linked to a wide variety of conditions including obesity, diabetes, heart disease, osteoporosis, hypertension, muscle weakness, rheumatoid arthritis and numerous cancers.
Most people know that Vitamin D is necessary to maintain strong and healthy bones; but Vitamin D is also a hormone. Vitamin D is unique in that your body can synthesize Vitamin D in your skin during sun exposure. Once activated in the liver, Vitamin D helps to regular the levels of calcium and phosphorus in the blood stream, which in turn affect the bones, circulation system and immune system as well.
The longer daylight hours of summer provide a great opportunity to optimize your health by having some fun in the sun. While it is true that excessive sun exposure can increase the risk of sunburns and skin cancer, the current trend toward avoid sun exposure altogether has been shown to have negative health effects. Sun exposure in moderation has several vital health benefits, which should be balanced against the risk of certain types of skin cancers cause by excessive sun exposure. One of the key benefits to sun exposure is maintaining optimal levels of Vitamin D.
Your body actually needs at least 20 minutes of direct sun exposure two to three times per week in order to produce an adequate amount of Vitamin D. People at increased risk for Vitamin D deficiency, include the elderly obese, dark skinned individuals, lactose intolerant individuals, and those with limited sun exposure. Common dietary sources of Vitamin D include fortified milk, salmon, tuna fish, and eggs. Because most people do not consume adequate quantities of these foods, vitamin D supplementation is necessary to achieve the recommended daily allowance of 600-00 IU of Vitamin D per day for adults. If you are concerned that you may have a Vitamin D deficiency, the best way to determine your risk is by asking your healthcare provider to run a blood test to check your Vitamin D levels.
In addition to boosting Vitamin D levels, sun exposure has also been shown to elevate mood by boosting serotonin levels as well as improving sleep and promoting weight loss. Below are a few tips to help you receive the benefits of sun exposure while minimizing the risks of sun burns which lead to skin cancer:
Always protect your face and ears with sun screens and hats as they are the most susceptible to skin damage.
Allowing 20 minutes of unprotected sun exposure to your arms, legs and trunk before 10am and after 3pm three times per week should provide adequate Vitamin D levels while minimizing the risk of sun burns and skin damage.
If you plan to be in the sun for longer periods, remember to find adequate shade and use sunscreen and sun protective clothing.
Now that California is re-opened, take advantage of the great outdoors and catch some sunshine - it will help to boost your mood and Vitamin D levels for improved health.
Hospice of the Valleys serves hundreds of patients each and every year. We honor them by sharing their stores. They remind us every day of the meaning and purpose in our work and that human connection is at the heart of the hospice experience. The following are notes Hospice of the Valleys has received from the families of patients that we have been privileged to provide hospice care.
"From the bottom of my heart - on behalf of my family, I am humbled and grateful for your compassion and loving care for my aunt. I made it through because of all of you."
"Thank you all for the excellent care of my husband. Your caring, love and support is much appreciated."
Turning the Corner on the Pandemic
By: Dr. Leslee B. Cochrane Executive Medical Director
It has now been nearly a year and a half since the first case of Covid-19 in California. This pandemic has been difficult for all and devastating for many; but we are now seeing numerous encouraging developments in the fight against the pandemic. I thought it might be helpful to hear about some of the positive developments, which have taken place over the past couple of months. On April 6, 2021, California Governor Gavin Newsome announced that if the current progress against the pandemic continues, California is on track to re-open all businesses effective June 15! On April 14, the Governor announced that he anticipates that California students will be able to return to school in person this August. According to the CDC, on April 27th, California had the lowest Covid-19 case rate of any state in the country! On April 30, Disneyland re-opened at 25% capacity with masks. On May 12, the CDC approved the Pfizer Covid-19 vaccine to be used in children as young as 12 years, greatly expanding the availability of vaccine to adolescents.
All patients age 12 and older are now eligible to receive the Covid-19 vaccination in the State of California. To date more than 1.9 million vaccine doses have been administered in Riverside County (population of approximately 2.5 million). I recommend that each person discuss the risks and benefits of the various vaccines with their doctor to determine if the Covid-19 vaccine is right for them. One of the most challenging aspects of the Covid-19 pandemic has been protecting our frail elderly residents who are most susceptible to the serious adverse effects of infection with Covid-19. As more and more residents and health care workers have been able to immunize against Covid-19, we have seen a continued drop in the number of new cases in nursing home residents over the past several months.
On May 21, the Riverside County Department of Public Health launched a new program to provide Covid-19 vaccinations to homebound patients within Riverside County who are unable to leave their home to receive the vaccine. The Riverside county Department of Public Health has signed a $300,000 agreement with United Lab Services to provide Covid immunizations to those patients who are homebound and not able to leave their home to receive the Covid vaccine. if you know of a homebound patient who would like to be added to the list of homebound individuals seeking vaccination, call 833-422-4255, or click https://myturn.ca.gov/ to find out information regarding the available vaccination program near you.
A New Twist on Finding Inner Peace
By: Dr. Lynn Euzenas Director of Spiritual Care & Bereavement Services
Inner peace is a treasure. We all want a bit more of it. Daily we try to add things to our daily routines to enhance it, such as a quiet walk, connecting with loved ones, or meditation. I've rarely seen someone suggest things we can remove from our daily rounds to move us closer to inner contentment. An insightful article by Amy Morin suggests ten such things. I want to share my own twist on them with you as a helpful means of giving your souls a bit more breathing room.
Make less time for truly toxic people: We all know people who are "energy vampires" those who drain your emotional energy, either intentionally or not. Kindly regulate your own ration of these folk. It's okay to say "not today."
Practice less self-blame: Most of us are highly skilled in finding ourselves lacking or beating ourselves up for things which we really can't claim blame for. Be more gentle with yourself.
Stop chasing happiness: Happiness is wonderful, but chasing it often moves us beyond feeling the happiness in the moment. Ask yourself, what's good, or beautiful, or fulfilling about this very moment. You may find some of that elusive happiness right now.
Give up trying to stay comfortable all the time: Constant comfort is lovely, but the reality of life is that often change and growth come of some struggle, challenge, and even pain or discomfort. Don't miss seeing how a balance of these things is essential to staying fully human.
Lose the victim mentality. We have met Eeyore, that gloomy and pessimistic old grey donkey in "Winnie the Pooh." By staying too long in a victim mentality we usually lose something essential to who we are: like Eeyore who often misplaces his tail.
Think about how exhausting trying to impress people can be. This is a simple one: practice just being "you" for all the unique goodness you are. There's no one else just like you: and that's a good thing!
The pursuit of perfection is a constant reminder of how far from that goal we actually are. Can we truly in our lifetimes win the perfection victory? At what cost?
Holding grudges is a huge time bandit. Grudges are heavy. They weigh a lot when added to all the other rocks we cart around with us. They are rarely a winning proposition. Give yourself a break. Put it down and lighten the load.
Seeking material things is a spirit killer: One question is a good remedy for this quest: could that material item you are chasing replace the deep joy of being with your loved ones?
Stubborn self-reliance can box you in a corner: Some of the most wonderful inner peace to be had is that feeling when another person reaches out and offers help. Receiving that help is comforting and transformative. Being too stubbornly self-reliant can block you from this gift.
Trying to practice even one of these things can surprise you with that soul deep inhalation and exhalation of your breath, and the relief which comes of touching your own inner peace. How will you chose to enhance your inner peace this week?
