Serenity Hospice of Ohio (Blog)

September is National Fruits and Vegetables Month. This gives opportunity for us to bring attention to the health benefits of adding fruits and vegetables to our daily diets. Many people find the addition of fruits and vegetables helps to eliminate disease and live long healthy lives.

Nutritionists believe having a wide variety of fruits and vegetables can give you the vitamins and minerals your body needs. Here are some of the healthiest fruits and vegetables to consider adding to your diet:

Blueberries Blueberries are low in calories and high in antioxidants. They can help lower blood pressure and in turn reduce stress.

Sweet Potatoes Sweet potatoes are a great source of vitamin A which helps create great vision. They are a fiber-rich food which helps maintain a healthy gut and digestive tract. Sweet potatoes are a highly nutritious food that can contain cancer fighting properties.

Avocado Avocados contain healthy fats that help our bodies to absorb them and use them for the energy we need. They are great for our hearts and lower our risk of heart disease.

Citrus Fruits Citrus fruits are rich in vitamin C. They contain antioxidants that can help support our immune systems and keep us from getting small seasonal viruses to severe long term diseases.

Tomatoes Tomatoes contain a special type of antioxidant called lycopene which also gives them their red color. These antioxidants play a big role in reducing risk for heart disease, diabetes and stroke. A fun fact is that tomatoes are one of the only foods that increases nutrients when cooked, unlike other fruits and vegetables.

Kale Kale is one of the most nutrient-dense foods available to us. It contains lots of vitamins and minerals that can help you to maintain a very healthy long lasting life. Kale contributes to your overall health including skin, eyes, heart, blood and immune system, all of your major organs to keep you healthy

These are just a few examples of some of the fruits and vegetables that you can add to your daily diet to make sure you are living your healthiest life. Our advice to you is to add color to your plate at every meal with some of these choices. Instead of using medications, let food heal you from the inside out.

As I write this it is July 18, 2022. Today would have been my brother Jeff's 57th birthday. He's no longer here to celebrate with us.

On September 6, 2015 we found out my brother had committed suicide. It was intense. It was devastating and it disrupted my life. It didn't matter that I had dealt with death dozens of times before. I had never dealt with the unexpected, unexplainable death of my brother.

And believe me when I tell you people said some crazy stuff to me. But even before this there were things I heard all the time from people who know a griever. "I don't what to say." "I don't know what to do." "They just cry all the time." "What if I say the wrong thing?"

My hope is to share with you what "not to say" to someone who is going through a difficult time but also offer suggestions of what to say instead. The difficult situation doesn't have to be a death, maybe it's a diagnosis or a divorce.

And please don't beat yourself up. Some of the things that I'm going to tell you not to say, you've already said. So have I. We've all said them. We didn't know any better.

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1. Don't Minimize or Deny Their Pain

Don't Say:

"At least you had ____ years together," or "At least they're not suffering anymore." Either of these comments may be true, but they minimize the loss and kind of suggest that the griever shouldn't be grieving.

"It was God's will" or "He/She is in a better place now." This is not the time for a theological discussion. In general, this comment does not help grievers feel better.

"You can have other children, get remarried, you have other siblings." These comments imply that people are replaceable, they are not.

"Time heals all wounds." Actually, time alone does not heal. Time plus active grief work does lead to a kind of "healing," but the loss will still be a lifelong aspect to their lives now.

Do Say Instead:

"You must miss him so much." "It is devastating to lose a loved one." "I can't imagine how painful it is to lose someone you love so much."

You don't want to try to minimize their loss. You can't take away their pain. Instead, use words that validate and empathize with their pain.

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2. Don't Offer Vague Attempts to Help

Don't Say:

"Let me know what I can do to help." Many kind, well-meaning people said this to me and they sincerely wanted to help. The problem was that I had no idea what I needed so I couldn't tell someone else what I needed.

"Call me if you'd like to talk." Grievers rarely have the energy to reach out. Don't put the burden on them to call you.

Do or Say Something Concrete Instead:

"I'll call you tomorrow and we can talk if you feel up to it." "Here's a casserole to take the pressure off of dinner tomorrow night."

Just show up with a basket of cookies, a homemade dinner or a bouquet of flowers. Or show up and wash their car, mow their lawn or take care of their kids for an evening. Also call and just check in, letting them know that you're thinking about them.

If they don't return your calls, don't take it personally. Some people will want a friend to listen and others would prefer to retreat. Still others may prefer the anonymity of an online support group. Either way, reach out and then respect their wishes.

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3. Don't Expect Them to "Get Over It" or "Be Their Old Selves"

Don't Say:

"Isn't it time that you move on, get over this, quit wallowing?" Grief has no time line. It's not a two-week, two-month, or even two-year process. Closure is a myth. In fact, grief is a lifelong process and is not something that you get over. Grievers must learn to live with loss and integrate it into their new experience of the world.

"When will you be your old self again?" The answer is "never." After a major loss, an individual is irrevocably changed. Understand that they are going through a process of intense growth and change. Be patient as they discover who they are.

Do Say Instead:

"I know you will always have their love in your heart." Just because the physical form of the person has died, does not mean that the relationship has died. A new relationship is emerging, based on love and memory and spirit. Honor the fact that they will have a continuing bond with their loved one.

"I know that you're becoming a new person and I'm here for you as you grow." How they interact with the world is different now. They are growing and you want to support that process.

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4. Don't Ignore Their Situation

Don't avoid someone or not acknowledge their loss because you don't know what to say or because you don't want to upset them. By ignoring their experience, you make them feel as if their loss doesn't matter.

Do Say Instead:

"I can't imagine what you're going through but I'm so sorry for your loss." "I am heartbroken for you."

Acknowledge their loss. If you knew the person who died, share a story about them. Grievers love to share memories and hear stories about their dear ones. If they happen to cry in your presence, that is perfectly okay! Tears are a natural way to move emotion through the body.

Know that if your heart is open, you will find words and deeds of compassion. And when words are simply inadequate, the healing power of a heartfelt HUG cannot be underestimated.

I didn't hold it together so well the first time I sat with someone who lost a loved one. I was working at a church where the custodian always listened to a police scanner. She rushed into the office and said an elderly member of our church had just committed suicide in his basement.

He lived less than a block away from the church with his wife but their children lived 20 minutes away. I couldn't get the image of the wife sitting by herself out of my head while the police and EMTs were all around her. So I decided to go sit with her.

I wasn't even a pastor then. I worked with the children and youth. I had no idea what to do or say. I just knew she shouldn't be alone. So I went and sat next to her on the couch and held her hand.

We in the business call that the ministry of presence. Sometimes the best thing you can do is sit next to someone and say nothing.

For years I have told grievers that you can't take anything personally that someone says to you when you are grieving. Learn the lesson from Frozen and Let It Go!!

Feel free to reach out and share stories of things people have said to you when you were going through a difficult situation. jsmith@serenityhospiceoh.com

In 2015 we started noticing that my Dad was getting more forgetful.

At first, we just assumed it was a part of aging but it was more than that. Mom said they would leave the house with Dad driving and he would forget where they were going.

In early 2016 Dad had a stroke which caused Vascular Dementia. In many ways we were lucky. Dad always knew who we were, when we were with him. He retained his sense of humor and his ability to have conversations. He also continued to be cranky and irritable.

Mom knew from the beginning that she would not be able to keep him at home and care for him herself. I applaud her for making this realization. If she would have tried to care for him, he would have refused to listen to her and would have made her life difficult.

The first nursing home couldn't handle Dad when he acted out. The second place was wonderful but Dad didn't like being around all those "old people." It was a facility that specialized in memory loss and in the area where he was the other residents couldn't carry on a conversation.

The third skilled nursing facility was the one for him. There were higher functioning people for him to interact with. There were activities that we could take him to and we could join him for meals.

So here are the first two tips:

1. Don't be afraid to put your loved one somewhere they can receive care from professionals. Sometimes that's what's best for everyone.

2. If at first you don't succeed, try, try again. We thought the first facility was the perfect choice, it wasn't. Moving isn't easy but it may be what is best for your loved one.

On several occasions, I would pass my sister leaving a visit with Dad as I was arriving for a visit. We would chat about her visit then when I arrived at Dad's room I would ask him, "Have you seen my sister lately?" Dad would reply, "Nope. I haven't seen her."

Sure, I could have tried to explain to him that she had just been there but it would have frustrated both him and me and that would have caused us to have a terrible visit.

Mom would visit Dad on the same day and time each week. Dad looked forward to those visits knowing she was coming and that she would have lunch with him.

Did he remember this? Probably not but we had a dry-erase board in his room where we would write things like that. So, every day he would read it. The staff at his facility was great about updating the date on his board each day.

The next tips:

3. Don't argue or try to explain the truth to someone with dementia. Just agree with them and move on.

4. Keep a routine. Even simple things like bathing, dressing, and eating at the same time each day.

5. Write down appointments and events. This helps both your loved one and the staff if they are in a facility.

Often during visits, I would tell Dad I had seen a Gold Finch bird, whether I had or not, because this would spark a memory from Dad's childhood and he would tell me the story about all the Gold Finches around his childhood home. This would often lead to another story.

Other times I would point out the pictures of the grandkids on the wall and I would tell him their name, where they were and what they were doing. Mostly he would listen but sometimes he would ask questions.

More tips:

6. Encourage a two-way conversation for as long as possible.

7. Try distracting the person with an activity, such as a familiar book or photo album, if you are having trouble communicating with words.

No two people are the same so not all these ideas will work with everyone but give them a try and see if they work for you and your loved one. Also, feel free to reach out if you want more tips and ideas for ways to interact with your loved one who has dementia.

By: Rev. Jill A. Smith

Dementia is a diagnosis that looks different on everyone.

It can be hard to know when to make certain healthcare decisions, especially is the physical decline is a slow process. Here are some helpful signs to look for if you are thinking Hospice may be an option for a loved one.

Increased Hospitalizations

If you find your loved one in and out of the hospital, without reason for admission this may be a good reason to call for a hospice evaluation. Emergency room visits and hospitalizations can be very scary and confusing for someone with dementia. Bringing hospice services in can help to cut down or eliminate hospital visits all together.

Increased Confusion

If you start to see a cognitive changes in your loved one that you have not seen before, this may be a reason to call hospice. The hospice team learning your loved one’s baseline as soon as you start to see the decline happen can be very beneficial to understanding what the long-term care plan should look like and what interventions need to be in place to keep your loved one comfortable.

Multiple Falls

Multiple falls can be dangerous for your loved one and again can lead to confusing hospitalizations. Bringing hospice on board can help get safe interventions into place and decrease hospital visits. Keeping your loved one safe and comfortable is a huge benefit to bringing hospice services on board.

Difficulty Walking

Physical changes in walking and transferring can be a great reason to call for a hospice consult. Hospice can provide medical equipment such as walkers and wheelchairs to help with your loved one’s mobility as these changes begin to happen.

Increased Assistance with Daily Activities needed

Often, those with a dementia diagnosis become confused or scared to do daily activities such as bathing, brushing teeth, grooming, toileting etc. If there is an increase in assistance needed for these daily activities, it may be a good time to contact hospice. Hospice provides a state tested nursing assistant twice a week to help make sure your loved one is getting the proper assistance and training care givers to assist as the needs change.

Changes in Appetite

Nutrition helps the brain to function, if you notice a change in appetite, it may be a good time to contact hospice. Changes in appetite can lead to weight loss and decline in cognitive function. Hospice can help promote a comfort diet and guidance to the caregiver to help make sure your loved one is comfortable throughout this phase of the disease progression.

Hospice can be a very difficult decision to make, however there are so many benefits offered to those with a dementia diagnosis. It is always ok to contact hospice to inquire if your loved one may qualify for these Medicare-covered services.

March is Spiritual Wellness Month

I'll be honest, when I heard that March was Spiritual Wellness Month my first thought was, "what the heck does that mean?" As one of the chaplains for Serenity Hospice and a minister, I kind of operate under the philosophy that during every month we should be well with our spirit. Every month we should be caring for ourselves spiritually, as well as physically and mentally. But do we?

We probably all know that we should participate in some regular physical activity. According to [health.gov][2] we should be doing 2.5-5 hours per week of moderate physical activity. Which means walking at least 30 minutes, 5 days a week.

In addition, they suggest doing muscle-strengthening 2 days a week.

I discovered this information by Googling "how many hours of physical activity is recommended weekly for adults?" Imagine caring for your spirit that much. So, I Googled it, "how many hours of spiritual activity is recommended weekly for adults?"

The first article talked about doing physical activities to improve your spiritual wellness. Most of the articles assumed I was asking about physical and mental health rather than just spiritual health. Not very helpful.

The truth is most people do nothing to boost spiritual wellness and those that do something usually spend about one hour on Sunday mornings sitting in church. Is that kind of like sitting on the couch and watching an exercise program?

Well, maybe it's time to get off the pew or yoga mat and DO SOMETHING to strengthen your spiritual health. Spiritual Wellness has many definitions, but all involve finding your meaning and purpose in life and aligning those with your morals. Most definitions also agree spiritual wellness includes doing things for others.

Now we're getting somewhere. Here are some things you can do to find meaning and purpose for your life. Oh, and I don't care how old you are, your life has meaning and purpose.

1. Connect with a faith community. Surround yourself with people who have similar spiritual beliefs.

2. Have quiet time. Meditate, pray, do yoga, be in nature.

3. Listen to your thoughts. When you feel that nudge or that little voice inside you, pay attention to it. Follow through. If it tells you to call somebody you haven't connected within a long time, trust it and do it.

4. Journal. When you keep a record of thoughts and ideas. You're more likely to follow through on them.

5. Speak with a chaplain or someone you trust to help sort through your thoughts and ideas.

Here are some things you can do for others.

1. Volunteer.

2. Check on your neighbors.

3. Write a thank you note to someone who has impacted your life and tell them how much they mean to you.

4. Donate - time, money, items, or services.

5. Be kind, say kind things, show kindness to others.

It almost sounds like if we all practiced some Spiritual Wellness the world would be a better place. It's worth a try, both for your sake and the world's sake.

Happy Spiritual Wellness Month!

Rev. Jill A. Smith Serenity Hospice, Chaplain / Community Educator