With Dr. Ellen Middendorf Classes of Medications In this months Medical Minute, we will begin to dive into which classes of medications should be on the hot seat for removal/deprescribing. In other words, what types of medications lose their luster or purpose as we enter end-of-life care. Hospice care is about palliating symptoms and improving quality of life once the patient has opted to discontinue aggressive treatment for his/her life-limiting illness. Thus, medications aimed at prevention, slowing progression or those with concerning current or possible side effects are of utmost priority ..read more

It’s no secret that being a caregiver is a large undertaking. According to the National Alliance for Caregiving and AARP, family caregivers spend an average of 24.4 hours per week providing care. In today’s world, many of us are more transparent about our mental health. Therefore, it’s not uncommon to hear about the mental strain a family caregiver may be experiencing. Feelings of guilt, exhaustion, frustration, and anxiety are all common when taking on the role of a caregiver and can make an already challenging time harder. Signs & Symptoms of Caregiver Guilt Detachment– A feeling of go ..read more

By Ellen Middendorf, MD- Medical Director of Hospice of Southern Illinois General Inpatient Care, commonly referred to as GIP, is one of the four levels of available hospice care. As the name implies, this is hospice care provided to a patient in an inpatient setting. CMS allows this care to be provided only in a Medicare-certified hospice inpatient unit or facility, a Medicare-certified hospital, or a Medicare-certified skilled nursing facility, though the latter is less common. The hospice works with the inpatient medical team to coordinate services and manage symptoms. The caveat for this ..read more

As of May 11th, 2023, the federal government lifted the COVID-19 PHE declaration. The COVID-19 pandemic has certainly been a challenging time for everyone. It’s hard to believe that it has been over three years since news reports first alerted us about cases of the novel coronavirus in the U.S. Since then, we have seen the disease spread everywhere, resulting in widespread shutdowns, restrictions, and changes to our daily lives. The declaration of a pandemic by the World Health Organization and a national emergency by the U.S. Government were significant events that marked the seriousness of t ..read more

By Ellen Middendorf, MD- Medical Director of Hospice of Southern Illinois As the Medical Director at Hospice of Southern Illinois, I use the term “case manager” often in my day-to-day duties. It might be in terms of a request to have the case manager address a medication issue or the case manager follow up on an x-ray or laboratory result. However, I never spent much time considering what case management truly meant for our patients and their families. I just know that the system works, and it works well.  However, after a family member of mine suffered a very serious injury in December ..read more

There comes a time where we all need a little extra help! Transitioning loved ones to a senior living community can be stressful and overwhelming. Many questions can arise, and information is key in making this important decision. What are the Different Types of Senior Living? The following Senior Living Community categories can be stand-alone or be part of a campus that includes several levels of care. Traditionally, types of Senior Living may be referred to as Levels of Care. Independent Living (Private Pay) Independent Living is perfect for individuals 55+ who are able to manage their ..read more

Dr. Ellen Middendorf Medical Director of Hospice of Southern Illinois. Our goal in hospice care is to improve quality of life. At Hospice of Southern Illinois, we are experts at managing pain and symptoms related to terminal illnesses. We utilize an interdisciplinary team, including a physician, nurse practitioner, nurses, social workers, bereavement counselors, and hospice aides to provide care to patients and their families. Patients can experience a variety of symptoms at end of life. For example, symptoms may include pain, dyspnea or shortness of breath, constipation, nausea and vomiting ..read more

The International Forum for the Study of Itch defines itching, medically known as “pruritus”, as the unpleasant sensation that provokes an urge to scratch. Conditions specific to the skin, underlying systemic issues, or a combination of both can cause itching. Pruritus is a relatively common and frequently frustrating symptom encountered in end-of-life care. Common Causes Dermatologic conditions, such as dryness, wetness, or irritation from eczema, psoriasis, or local irritants, most frequently cause localized pruritus. Skin naturally dries as we age, and hydration of the skin is the primary ..read more

When we all think about medication administration our mind naturally goes to swallowing a pill or a teaspoon of cough syrup, for example. This route of medication administration is by far the most common and preferred. However, there are often circumstances that prevent the oral use of medications. These can include the inability to swallow, whether due to a decreased level of consciousness or an oral or gastrointestinal lesion, severe nausea and/or vomiting, or bowel obstruction. When these issues arise, prescribers must look to alternative routes of medication administration to meet patient ..read more

In hospice care, our primary goal is to maximize patient comfort while adhering to a patient’s and family’s goals of care. We work to accomplish these goals by employing an interdisciplinary team approach to address all aspects of the patient’s plan of care. Of course, medications are a mainstay of our treatment plan to ensure patient comfort and symptom palliation. A class of medications that can elicit questions on benefit and purpose is certainly antibiotics. Proper Use of Antibiotics I would imagine that most of us have been prescribed an antibiotic for some ailment throughout our lives ..read more