News and Events

Does My Child Need Grief Counseling?

Grief is a natural human response to change, death and impending loss. Because grief can be so painful and overwhelming, it often frightens us. Many people worry if they are grieving “the right way” and wonder if their feelings and reactions are normal. Children are no exception to the turmoil of the grieving process, but their reactions and feelings may be difficult for adults to understand.

Children, who are still in the midst of mental, psychological, spiritual and emotional development, often react to grief very differently than adults. It falls to the parents, caregivers and counselors to recognize how the child is coping during this difficult time so that they can provide needed support.

Although there is no “rulebook” for how children should grieve, certain types of reactions to grief are common in preschool and school-age children.  Other less common reactions may be a sign that your child needs more support, perhaps with a professional grief counselor. Following are examples of common behaviors that you can expect to see in grieving children, in addition to warning signs that may indicate that a child is in need of grief counseling.

 

Common Reactions to Grief in Children:

Emotional Reactions

  • Shock and disbelief—the death seems like a bad dream that will not go away.
  • Confusion or absent-mindedness.
  • Longing for what used to be.
  • Withdrawal and avoidance of others.
  • Numbness or moodiness.

Physical Reactions

  • Changes in appetite or eating habits.
  • Difficulty sleeping.
  • Fatigue or lack of energy.

Behavioral Reactions

  • Sudden change in school performance or behavior.
  • Periodic loss of interest in schoolwork or favorite activity.
  • Apathy and lack of motivation.
  • Explosive emotions, upsetting and difficult to control.

 

Warning Signs/Complicating Factors Indicating a Need for Grief Counseling:

  • Poor relationship and communication between child and parent.
  • Other losses have occurred recently.
  • Death causes relocation or other significant lifestyle changes.
  • Child won’t discuss the death with trusted adults.
  • Death was unexpected, abrupt or traumatic.
  • Terminal illness that involves significant physical or mental changes in the loved one.
  • Death has been concealed or not explained.
  • Child expresses persistent obsessive thoughts and preoccupation with the deceased.
  • Persistent loss of interest in schoolwork or favorite activity.
  • Sudden personality changes (for example, an outgoing child becomes unusually withdrawn).
  • Frequent irritability or unexplained crying.
  • Preoccupation with pain, death or suicide.

Typical grief reactions can vary depending on a specific child’s age and social/cognitive development. Kids Path counselors are available to consult with any parent, caregiver or school about how best to support a child with loss related to death or severe illness.

Call 336.544.5437 and ask to speak with a counselor.

 

The Selfless Act of Self-Care

When caregiving for a loved one who is seriously ill or nearing death, taking care of yourself often falls to the bottom of your priority list. “I’ll be fine,” “Don’t worry about me,” “She/he is my priority” or “I have too much to do” are common responses given by caregivers when presented with questions about their well-being.

When your loved one is seriously ill, in pain or approaching death, going home to shower and get some sleep can feel selfish or frivolous.

Although staying by your loved one’s side is a wonderful and caring thing to do, doing so while neglecting your own well-being will end up negatively impacting both of you.

Caregivers who neglect their own needs run a high risk of illness, burnout, emotional or mental distress and physical damage. The longer a person goes without addressing their basic needs, the more severe those consequences can become.

The most selfless thing caregivers can do is practice regular self-care. Doing so will:

  • Ensure that they are able to provide care for longer without burnout.
  • Improve the quality of care given.
  • Reduce or eliminate the risk of prolonged absence from caregiving due to mental or physical illness.
  • Provide emotional respite that allows for more genuine and meaningful contact with loved ones.
  • Provide mental respite that allows for better processing of complex medical, financial or advance care planning duties.

Caregiving is a stressful job, so creating a plan or schedule for self-care may help by eliminating the need to make decisions in the moment. For example, if your schedule includes eating dinner by 7 p.m. each evening, you don’t have to worry about “forgetting to eat.” Just as you wouldn’t skip your loved one’s scheduled medications, neither should you skip or push back your self-care tasks. You should consider your self-care schedule to be inflexible and high-priority.

Here are some self-care priorities to keep in mind:

  • Shower and change clothes daily.
  • Eat three healthy meals per day.
  • Spend time away from your loved one.
  • Participate in light exercise regularly.
  • Get eight hours of sleep per night.
  • Talk to a friend, family member or counselor about your feelings.

Below is a sample self-care schedule.  You can make one yourself by downloading a blank self-care schedule template here.

Daily

8-8:30 Shower
8:30-9 Breakfast
1-2 Lunch
3-3:30 Take a walk
5-5:30 Talk to family  or friends on the phone
7-8 Dinner
11 Sleep

 Weekly

Mon, Wed, Fri Sleep near loved one (hospice, home, facility)
Tu, Th, Sa, Sun Sleep at home
Mondays from 4-5 Counseling
Thursdays from 3-4 Yoga Class
Sundays from 11-1 Church

Benchmarks:

  • Eat fast food less than three times per week.
  • Get an average of eight hours of sleep per night each week.
  • Eat at least one meal per day outside of your loved one’s home or room (at a restaurant, at your home, with a friend, outside).

Why do you Volunteer with Hospice?

In honor of National Volunteer week, Bill Spaulding (pictured below) shares the motivations behind, and the impact of, his volunteer service with Hospice and Palliative Care of Greensboro (HPCG).

 

As a relatively new HPCG home visit volunteer, I’m surprised by how frequently I get asked the question, “Why do you volunteer with hospice?” It comes not only from my friends and acquaintances, but also from the caregivers for whom I provide relief. My typical answer is perhaps a bit too simplistic:

“I find it to be a way to give back.” 

Life has been pretty good to me. In the past, I have sought out a variety of ways to volunteer my time. I’ve worked with elementary school children to develop their academic skills, with an organization that serves the homeless, and with adults who have English as a second language to develop their literacy skills. I’ve found all of my past volunteer activities to be rewarding and suitable ways to give back.

But something deeper comes from serving as a hospice volunteer; the simple answer, I find it to be a way to give back,” feels incomplete. There is a spiritual benefit that surpasses anything I have known in my previous voluntary efforts. Maybe spirituality—like death, dying, and end-of-life transition—is one of those topics I don’t have much experience discussing. Perhaps I too have seen these topics as taboo in “polite” conversation. Maybe I’ve too long relegated talk of death to the funeral parlor and discussions of spirituality to the church.

I must acknowledge that I don’t always go to bed at night feeling that I contributed to the greater good. My nighttime thoughts don’t often include: “I really did God’s work today!” Rather, I’ve found that serving as a hospice volunteer is a great way to find the divine in the simplest things.

One of my first hospice assignments was to go shopping for a woman who cared for her terminally ill husband in their home. She had meticulously prepared her grocery list so that I could easily walk aisle by aisle through the store, picking up each item sequentially as I went. After shopping, I returned to her home and placed the groceries on her counter. When she thanked me, tears of gratitude filled her eyes. You would have thought that an angel from heaven had appeared to meet her deepest need, yet all I had done was grocery shop.

This was just the beginning of my realization that I may never fully understand how my service benefits another. As I turned to leave she asked me with genuine amazement, “Why do you do this?”  My response was the understated “I find it to be a way to give back.”  When I went to bed that night, a whisper came to me from somewhere in the silence— “You did good today.

Being a hospice volunteer is so much more than just a way to give back.

Bill Spaulding, Hospice Volunteer

Every day, more than 200 HPCG volunteers serve patients, their families and our staff in a variety of ways. Regardless of their unique spiritual beliefs, age, background or skill set, they are united in their desire to give back. Learn more at hospicegso.org/volunteer/.

Chief Nursing Officer Joins Hospice and Palliative Care of Greensboro

Maria Thurlow, RN

(GREENSBORO, NORTH CAROLINA)—Maria Thurlow, RN, joined Hospice and Palliative Care of Greensboro (HPCG) as its chief nursing officer in February 2018. Thurlow was previously the chief culture officer at Advanced Home Care, Inc., where she served in various roles starting in 1996.

“For the past several years, I have felt pulled to hospice as a place to complete my career,” Thurlow said. “My mother was a patient of HPCG for more than a year, and I was impressed with hospice’s interdisciplinary approach to care as well as the focus on patient and family goals at the end of life.”

A registered nurse, Thurlow began her career in a medical intensive care unit. Over the past 25 years, she has held a variety of clinical leadership and executive roles in the acute care and home health setting. At Advanced Home Care, Inc., she was responsible for clinical, financial and quality outcomes, as well as talent support and cultural transformation.

“Maria has great experience leading patient care teams through periods of rapid growth, mergers and organizational change,” said Kristen Yntema, president and CEO of HPCG. “I believe her vast experience will help us achieve our goals here at HPCG in the ever-changing world of health care.”

HPCG is a nonprofit organization that serves an average of 350 patients per day in Guilford County and surrounding areas. It is situated on a 14.75 acre campus at 2500 Summit Avenue. Since 1980, HPCG has been providing physical, emotional and spiritual support for children and adults faced with a life-limiting illness, as well as their caregivers and families. For more information, call 336.621.2500 or visit www.hospicegso.org.

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Caregiving for the Aging Senses Part 3: Hearing

Hearing is a degenerative sense, meaning that it naturally deteriorates with age. The tiny hairs in our ears (called stereocilia) that process sound become damaged with age and exposure to noise. However, some aging people lose their hearing more quickly or profoundly than others.

Hearing loss has significant emotional and physical effects on aging people; it can be not only isolating and depressing, but also dangerous. As a caregiver, it is important to understand these hearing-related changes so you can make accommodations that improve quality of life.

The Effects of Hearing Loss on an Aging Person

  • Feelings of isolation, withdrawal from relationships or social interaction because of an inability to fully participate in conversations, especially in loud settings such as social gatherings.
  • Depression due to changes in social abilities.
  • Confusion when giving and receiving information, such as a doctor’s instructions.
  • Anger, frustration or irritability.
  • Embarrassment: Others will often assume that the presence of hearing aids is indicative of mental decline, and may talk down to or engage less with a person who wears hearing aids.
  • Dizziness and increased likelihood of falls (the inner ear plays a significant role in balance).
  • Inability to hear emergency alarms and sirens.
  • Cognitive decline: Isolation from conversation and entertainment can cause mental impairment in hearing-impaired people.

 

How can you help your hearing-impaired loved one be happier, more comfortable, and safer?

  • Make sure your loved one makes regular trips to a hearing specialist so that they can be given proper treatment (such as hearing aids).
  • Actively engage your loved one in stimulating conversation, and encourage family and friends to do the same.
  • Play challenging games with your loved one to keep them mentally fit.

 

 

 

 

 

  • Install rails and bars throughout your loved one’s living area to decrease the likelihood of falls. Also consider providing a cane or other stability device to offset dizziness and vertigo.
  • Install alarms and other emergency devices that have a visual component (such as a flashing light). Test these alarms around your loved one to see if they are loud and bright enough for them to reliably notice.
  • Plan social gatherings that are small, low-key and fairly quiet. This will allow your loved one to continue actively engaging socially without being overwhelmed by loud sounds

 

 

 

 

 

 

 

  • Have a health advocate who is not hearing-impaired attend doctor’s visits with your loved one. This will ensure that they have full understanding of whatever medical information they are given.

 

Resources:
https://www.healthyhearing.com/report/52508-How-hearing-loss-affects-seniors
https://www.healthyhearing.com/report/52548-New-research-links-hearing-loss-to-an-increased-risk-of-falls
https://www.hear-it.org/common-among-seniors-and-elderly-age-related-hearing-loss

Veterans Share Meaningful Experience at “Dunkirk”

Bob had a simple request of his hospice team: to see “Dunkirk,” a 2017 World War II film, in theaters after it was released. His preference was to view the movie with a fellow veteran.

“I was not in the service during the era this movie took place, but I did serve during the Korean War as a young man in the Air Force and thought I would be able to relate to this movie,” said Bob. “I was only in the service a few years, and afterwards I never wanted anyone to make a fuss about it.”

Hospice and Palliative Care of Greensboro (HPCG) believes it is never too late to thank veterans for their military service. The Vet-to-Vet volunteer program at HPCG matches veteran volunteers with veteran patients. In doing so, patients have the valuable opportunity to discuss their service with someone who understands.

Bob was partnered with an HPCG Vet-to-Vet volunteer named Joe. “It is truly an honor to serve as a volunteer with an organization that values the unique experiences of our veterans,” shared Joe. “The service members we serve come from all walks of life, but they all share several fundamental qualities. They possessed courage, pride, selflessness, dedication to duty and integrity—all the qualities needed to serve a cause larger than one’s self.”

Veterans often carry experiences from their military service that present unique health care challenges. By recognizing the needs of veterans who are facing a life-limiting illness, HPCG staff are better able to guide them and their families toward a more peaceful ending.

Joe felt privileged to be Bob’s volunteer. He too was interested in seeing “Dunkirk” and was honored to take Bob to see it.

“As the movie credits rolled and the people cleared the theater, we both sat quietly at first. Then Bob broke the silence and started discussing his own military experiences. And I just listened. That discussion was important for both of us that day, and it embodies our efforts to capture moments that really matter.”

Click here to learn more about the We Honor Veterans program at HPCG. 

Hospice Offers Free Lunch & Learn Series to Public

Presenter and guests

(GREENSBORO, NORTH CAROLINA)– Hospice and Palliative Care of Greensboro (HPCG) is excited to announce the new season of Lunch & Learn at the Lusk Center, a free lecture series designed to help participants with a variety of complex care and health issues. The 2018 lineup features presentations on several repeat topics from last year, such as advance care planning, as well as new subjects like navigating the caregiver experience.

Each hour-long workshop is presented by topic experts and held at the Lusk Center, a state-of-the-art facility with ample parking on the HPCG campus. Lunch is provided, along with practical, community-focused resources.

Each event is free and open to the public. All workshops take place from noon – 1 p.m. with check-in beginning at 11:30 a.m.

The program is made possible through generous support from Beverly and Patrick Wright, Pat and Gordon Soenksen, as well as the John A. Lusk, III Endowment Fund for Hospice and Palliative Care Education.

Visit www.hospicegso.org/learn for more information and to register.

Lunch and Learn at the Lusk Center
2018 Schedule


Palliative Care vs. Hospice Care:
What’s the difference?
Thursday, March 15
Discover the difference between hospice and palliative care, how these services can help and who pays for them.

Advance Care Planning:
How to plan for end-of-life decisions and talk about it with loved ones
Thursday, April 12
Learn about advance directives, why and when they’re used and how to start a conversation with family.

What Really Matters:
A meaningful discussion on changing priorities
Thursday, May 10
As the end of life nears, we have opportunity to reflect on what truly matters. Join us for a thoughtful, interactive discussion about the end-of-life journey and how to capture meaningful moments along the way.

The Caregiver Experience
Navigating Rough Waters
Thursday, June 14
Caring for a loved one can be the most demanding job we’ll ever have. Join us for a look at some ways caregivers can maintain—or regain—balance and hope.

Dementia Talk:
Why do they do that… and what can I do about it?
Thursday, September 13
Receive guidance in dealing with the four most difficult dementia behaviors: bath wars, social problems, aggression and agitation.

Beyond the Casserole:
How to Truly Support Grieving Friends and Family
Thursday, October 11
What gives real comfort to those who are grieving? Hear what deeply grieving persons wish others understood, and learn how to be of support to friends and family in grief.

 

About HPCG
HPCG, a nonprofit organization serving Guilford County and surrounding areas since 1980, is situated on a 14.75 acre campus at 2500 Summit Avenue. HPCG provides physical, emotional and spiritual support for children and adults faced with a life-limiting illness, as well as their caregivers and families. For more information, call 336.621.2500 or visit www.hospicegso.org.
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Caregiving for the Aging Senses Part 2: Touch

A tight embrace from a loved one. The soft warmth of a newborn baby on your chest. The soothing comfort of petting a dog.

Touch is our physical connection to the world, and more importantly, to those with whom we share our lives. When speech, hearing and vision begin to deteriorate with age or illness, touch is a powerful tool for communicating support and presence. Just holding someone’s hand can be the most effective support you offer near end of life.

As the body ages, so do our nerve cells, decreasing our ability to sense touch. These physical changes can manifest in a wide array of symptoms that range from uncomfortable to potentially dangerous. Being aware of how your loved one perceives touch as they age ensures that you are providing them with the care that they need, both emotionally and physically. For example, loss of fine motor skills, dexterity and reflexes mean that it may be more difficult to grasp objects, dial a phone or safely operate a vehicle.

Not feeling the sharpness of a knife or the heat of a stove can result in injury.

CAREGIVER TIP: Provide assistance with and/or close supervision of tasks such as cooking, cleaning or driving. Use your best judgment to determine whether it is safe for your loved one to continue doing these activities independently.

Decreased sensitivity also makes it hard for older adults to tell the difference between common surface types and temperatures. For example, being unable to tell that the shower floor is slippery increases the likelihood of slipping and falling. Lack of temperature awareness can result in burns. With all of these changes in the sense of touch, normal daily activities such as cooking may become dangerous.

CAREGIVER TIP: Ensure that all surfaces are safe for your loved one. This could mean using a rubber mat or stool in the shower, regularly icing walkways during winter, laying down carpet on bare floors or providing shoes and socks with good grip.

Muscle deterioration, poor circulation, fat loss and decreased nerve sensitivity impact the body’s ability to regulate temperature. As our bodies age, hypothermia can develop at temperatures as high as 65 degrees.

CAREGIVER TIP: Pay close attention to the temperature of your loved one’s primary residence. Try to keep it around 70 degrees or above year-round. If they live in an assisted living area where you can’t control the temperature, be sure to provide warm clothing and blankets.

Older adults may be unable to discern a difference in temperature unless it is greater than ten degrees.

In addition, lack of sensitivity to changes in temperature means that fever or hypothermia can progress without the sufferer’s awareness. An older person can develop an advanced infection and not be aware that they are even ill until it is a medical emergency.

CAREGIVER TIP: Pay close attention to your loved one’s body temperature so you quickly detect changes requiring medical intervention.

It is equally important to consider the emotional and psychological impact these changes may have on your loved one. Older adults can suffer from “touch hunger,” which is a feeling of desperation for physical contact. Just as we become hungry for food, we can also feel deprived of our primordial need to connect to another being through touch. Insufficient frequency or intensity of touch (both of which are common as we age) are risk factors for developing touch hunger.

CAREGIVER TIP: Provide plenty of soothing touch to your loved one (hugs, holding hands, foot rubs). Consider bringing in a therapy pet volunteer or a professional masseuse to provide further comfort.

 

Resources:
https://www.agingcare.com/articles/the-power-of-human-touch-187302.htm
https://www.seniorhealth365.com/health/hypothermia-in-the-elderly-and-first-aid-for-low-body-temperature/
http://www.scholarpedia.org/article/touch_in_aging 

Caregiving for the Aging Senses Part 1: Vision

It is no secret that eyesight tends to deteriorate with age. The age-old trope of a grandma with thick-lensed glasses is so ingrained in society that we practically expect our elders to have poor vision.

For people who have had good vision for most of their lives, losing the ability to rely on sight for interaction with the world can be extremely disorienting.

By understanding why and how the eye ages, caregivers can make small environmental adjustments that drastically improve the lives of their loved ones.

Loss of Focus

Simulation: 30 years vs. 80 years

 

As the lens of the eye ages, it loses elasticity and begins to harden.  In a young eye, the lens will bend when viewing something up-close, thus bringing the object into focus.

As it becomes stiffer, the lens can no longer bend sufficiently to focus on objects that are too close. This condition, called presbyopia, makes it difficult to read and can cause persistent headaches.

How to help:

  • Most aging people will eventually require reading glasses, bifocals or contacts. However, because the condition of eyes can change rapidly, make sure your loved one has regular eye exams to monitor the progression of their presbyopia. They may need to get new prescriptions every one to two years.
  • Provide bright, even lighting for reading or other activities that require up-close focus, such as knitting. Using light that is too concentrated (a single bright bulb) can cause glare.
  • Make sure your loved one has glasses or other corrective lenses specific to their daily activities. For example, playing the piano or using the computer might require a different lens than reading, as/because the object of focus is slightly farther away.

 

Darker Vision

Simulation: 30 years vs. 80 years


 
Aging pupils are decreasingly sensitive to changes in light, in addition to becoming smaller. Because older eyes cannot respond quickly to changes in light levels, turning a light on or off suddenly may impair vision for several minutes. Smaller pupils also absorb less light, meaning that an older person has a darker field of vision overall.

How to help:

  • Provide adequate lighting for your loved one’s entire living environment. The light may be brighter than you think is necessary, but remember that your loved one’s vision may be 10-40 percent darker than your own.
  • Keep bright (possibly even motion-activated) nightlights in bedrooms, hallways, bathrooms and any other areas that your loved one uses at night.
  • Be particularly attentive to your loved one when you are out with them at night, or even a dark place such as a movie theater. Keep in mind that they might not be able to see obstacles, changes in their walking surfaces, stairs or even other people.

 

Yellowing of Vision

Simulation: 30 years vs. 80 years


 
With age, and the resulting lifelong exposure to irritants, the lens of the eye gradually yellows. This can cause several distressing problems for your loved one, including trouble differentiating colors, dulling of color, and even changes in their circadian rhythm.

Blue light (think of bright daylight) triggers our body’s production of serotonin (a chemical that wakes us up), while yellow light (such as the soft lighting in your home) triggers the production of melatonin (a chemical that helps us sleep). Thus, as the eye’s lens yellows, it absorbs less blue light. The resulting drop in the body’s production of serotonin can adversely affect the circadian rhythm, and consequently, interrupt healthy sleep patterns.

How to help:

  • Install fluorescent or LED lighting, both of which emit blue light. By increasing the amount of blue light in your loved one’s environment, you can counteract some of the yellowing of their lens so that they see colors more accurately. This can also help restore normal circadian rhythm.
  • Assist your loved one with color-sensitive tasks, such as picking out an outfit.

If necessary, consult with a sleep specialist, who may be able to improve the quality of your loved one’s sleep.

 

For more information on age-related vision problems and how to help compensate, visit: http://www.visionaware.org/info/for-seniors/1

 

References:
https://www.aoa.org/patients-and-public/good-vision-throughout-life/adult-vision-19-to-40-years-of-age/adult-vision-41-to-60-years-of-age
https://nei.nih.gov/healthyeyes/aging_eye
http://www.visionaware.org/info/your-eye-condition/eye-health/normal-vision-changes/125

 

Tickets Now on Sale for Corks for Kids Path

(GREENSBORO, NORTH CAROLINA)– Hospice and Palliative Care of Greensboro (HPCG) will hold the 11th annual Corks for Kids Path fundraiser on Friday, February 23 at the Cadillac Service Garage in Greensboro. This wine-tasting event benefits Kids Path, an HPCG program supporting seriously ill and grieving children.

With a ticket purchase of $80, guests can sample a variety of handcrafted wines exclusively selected by Zeto Wine and Cheese shop, as well as locally crafted beer, hors d’oeuvres and decadent baked goods. The event also features an extensive silent auction.

Exciting changes are planned this year—most notably the venue. Cadillac Service Garage, a restored 1920s Cadillac showroom in the heart of downtown, promises to be a fitting space for the nearly 600 attendees.

Yet returning guests will find much of the fundraiser remains the same, including the many sponsors who make the event possible.

“We are so thrilled to have Crumley Roberts return as the presenting sponsor,” said Kristen Yntema, president and CEO of HPCG. “They have such a heart for Kids Path.”

Since its inception more than a decade ago, Corks for Kids Path has raised more than $1 million for Kids Path. This generous support means Kids Path can provide quality hospice care for children, along with counseling, camps and workshops to children who are grieving.

Tickets sell out quickly. Visit www.corksforkidspath.org to purchase.

About HPCG

HPCG, a nonprofit organization serving Guilford County and surrounding areas since 1980, is situated on a 14.75 acre campus at 2500 Summit Avenue. HPCG provides physical, emotional and spiritual support for children and adults faced with a life-limiting illness, as well as their caregivers and families. For more information, call 336.621.2500 or visit www.hospicegso.org.

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