Understanding THE SYMPTOMS YOU SEE

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Understanding THE SYMPTOMS YOU SEE Z Human existence is rich with experiences that weave a completed quilt called life. As the quilt nears completion, there is no set calendar as to its final, beautiful result. The process of piecing it all together can be intense, rewarding, overwhelming, even frustrating. But it is also a process that should be marked with enjoyment and cherishing of the commitment to it and the life it represents. That s what hospice allows. A gift of time, even in generous measure, where loved ones can focus on being together instead of difficult details. A gift of love, for as long as the journey continues, providing support and guidance that allows you to focus on sharing in moments to remember. Wings of Hope Hospice is privileged to be the only service of its kind located amid the communities of Allegan County. And as part of that commitment to you, our neighbors and friends in surrounding areas, please use this complimentary guide to help your family know when to bring the support of hospice into your home, or ours. The most important thing to remember is that hospice doesn t mean the end. Hospice means be free to enjoy each other to the fullest, as a new journey begins. *If you or a loved one are experiencing several of these symptoms, you may qualify for hospice care. Contact the Wings of Hope Hospice office at 269-686-8659 or 800-796-2676 for more information. Someone is available to talk to you by phone 24 hours/day, including holidays. **Source: Hospice Care: A Physician s Guide. 2009. Seventh edition. Used with permission from the Hospice and Palliative Care Association of Michigan.

ALS (Amyotrophic Lateral Sclerosis) Difficulty breathing when at rest Use of additional muscles to breathe, such as the shoulders Breathing more than 20 breaths per minute Voice growing softer Cough getting weaker Waking up often Sleepy during the day Unexplained headaches Unexplained confusion Unexplained anxiety Unexplained nausea Difficulty swallowing Cancer Disease spreading to other parts of the body Disease spreading to other parts of the body, even with treatment Individual has decided not to seek treatment Dementia Only speaking 6 or fewer words that are clear Losing or lost ability to walk, sit up, smile and hold head up Cannot walk without help Cannot dress without help Cannot bathe without help Unable to control bowels or bladder Had any of these in the past 12 months: Pneumonia

Kidney infection Blood infection Bedsores Fever General signs and symptoms Infections such as pneumonia that occur over and over Difficulty swallowing or food going down the windpipe Difficulty breathing Cough that won t go away Nausea or vomiting that won t go away Diarrhea that won t go away Pain that needs increasing amounts of medication Swelling, especially in the feet and ankles Weakness Change in level of consciousness Requiring more and more assistance with eating, dressing, bathing or walking A diagnosis of any of the following illnesses: Chronic obstructive pulmonary disease (COPD) Congestive heart failure (CHF) Other heart disease Diabetes Stroke ALS or Lou Gehrig s disease Multiple sclerosis Parkinson s disease Kidney failure Liver disease AIDS Dementia Lupus Rheumatoid arthritis

Heart Disease Not able to carry on any physical activity Discomfort with physical activity Chest pain even at rest Irregular heart rhythm that cannot be treated with medication History of heart attack or CPR History of fainting Blood clot in the brain HIV Disease CD4+ count < 25 cells/mcl Viral load > 100,000 copies/ml Lymphoma Mycobacterium avium complex (MAC) bacteremia infection not responding to treatment or individual has refused treatment Kaposi s sarcoma not responding to treatment Kidney failure Cryptosporidium infection Toxoplasmosis not responding to treatment Requiring much assistance and frequent medical care Chronic diarrhea Low blood protein Active substance abuse Older than 50 years of age Congestive heart failure with symptoms at rest

Kidney Disease Not going on dialysis Stopping dialysis Congestive heart failure On a ventilator or breathing machine Cancer in other part of the body Lung disease Heart disease Liver disease AIDS Internal bleeding Not urinating much Liver Disease Swollen abdomen Not urinating much Infection in abdomen Coughing up blood Enlarged liver Less strength and endurance Continue drinking alcohol Liver cancer diagnosis Hepatitis B diagnosis Hepatitis C diagnosis

Lung Disease Difficulty breathing when at rest Inhalers don t seem to help much or at all Individual does not move much beyond bed or chair Fatigued or tired Cough Visits to the emergency department Hospitalized for breathing difficulty Unintentional weight loss Heart beats over 100 beats per minute when at rest Stroke Cannot care for self, needs help Difficulty swallowing Food may accidentally go down the windpipe

Wings of Hope Hospice Address: 530 Linn Street Allegan, Michigan 49010 Phone Number: 269-686-8659 or 800-796-2676 www.wingsofhopehospice.com