Caregiving Beyond the Patient
Family Needs Matter Too
Our holistic approach to hospice care means we go above and beyond clinical care for the patient—our care extends to their family and caregivers, too. Knowing that spiritual support, emotional support, companionship and the ability to communicate with our care team for any questions can be reassuring and can alleviate stress for family members, the caregivers and the patient.
For many hospice patients, beyond physical care, a terminally ill patient will have emotional and spiritual needs. At Paradigm Health we understand that this extends to the patient’s family as well. Family and caregivers will need support, guidance, a listening ear, and connection with resources during and after the hospice journey. Our grief support program is one of the best in Indiana and extends for 13 months past the passing of a loved one. From online virtual support to spiritual connection and resources, Paradigm Health is with families every step of the way.

Hospice Care on Your Terms
At Paradigm Health we respect and support that every individual’s end-of-life hospice journey is unique. As changes or a decline in your loved one’s health is recognized by their health care team and the family, hospice care may be recommended if dying is likely within 6 months. Hospice care is a more specialized care for people with terminal illnesses.
Some hospice patients will have a gradual decline in health while others fade quickly. For friends and family members, roles are flexible but usually include being present, providing support and comfort, and reassuring their loved one will be able to maintain their comfort and dignity throughout the hospice care process. Paradigm Health hospice care focuses on the living and enriching and enhancing every day. Beyond comfort for the patient with pain relief, hospice also offers emotional and spiritual support for your loved one and family.
Some hospice patients will have a gradual decline in health while others fade quickly. For friends and family members, roles are flexible but usually include being present, providing support and comfort, and reassuring their loved one will be able to maintain their comfort and dignity throughout the hospice care process. Paradigm Health hospice care focuses on the living and enriching and enhancing every day. Beyond comfort for the patient with pain relief, hospice also offers emotional and spiritual support for your loved one and family.
End-of-Life Signs, Symptoms and Support
Our caregiving team led by Paradigm Health’s board-certified medical director are experts at creating and implementing a plan of care based on goals that are unique to every individual’s hospice journey. While the below list of signs and symptoms that hospice care may be needed are often seen in patients, you or your loved one’s symptoms are specific to their own health care signs and diagnosis.
Pain
Changes in sleep patterns
Shortness of breath
Changes in blood pressure, heart rate, or body temperature
Anxiety
Decreased appetite and thirst
Less interaction or verbalization
Nausea or Vomiting
Constipation or change in bowel habits
Fatigue
Withdrawal or a drifting away from loved ones
Delirium and Restlessness
Incontinence
Cold hands and feet; skin mottling
Respiratory rattling
If you or a loved one are experiencing any of these signs or symptoms, please reach out to Paradigm Health for assistance in seeking the right support and identifying a plan of care that is unique to your needs. Our physicians, nurses and community-based hospice care team are experts in end-of-life care and can asssit in treating a patient for any symptoms they may be having and do so as quickly as possible. They have a multitude of options to assist with pain and symptom management including medications, non-pharmacological resources and emotional and spiritual support.
Calming Responses to Common Symptoms
Terminal Restlessness
It may be noticeable that a hospice patient seems restless and not at rest. They may be making repetitive body motions or pulling at covers without accomplishing a solution. A decrease in oxygen may be the cause. Making sure to remain calm yourself, speaking softly, reading a calming passage, playing soft music, or offering a light touch may be helpful and reassuring.
Shortness of Breath
Many hospice patients will experience changes in their normal breathing patterns. They make take more shallow breaths with longer periods of time between breaths. While sometimes unnerving, these breathing patterns are common and are most likely in response to a slower circulatory system. Remain calm and offer to shift the patient on their side, prop them up with pillows to elevate the torso, or bring comfort by a calming touch, or offering soft voice.
Navigating the Hospice Journey
From Experience: A Hospice Nurse’s Journey
The Hospice Journey — Unique to Every Patient and Family
End-of-life signs begin a flexible and unique hospice journey for patients, families and caregivers. Oftentimes, but not always, the dying process begins approximately two weeks prior to death. A shift in a person’s mental processing of death arrives at a true comprehension of their own mortality. Some physical, mental and spiritual signs that a person may be nearing death may begin to happen months prior to actual end of life. In the book Paradigm Health shares with many of their patients and families called “Gone From My Sight,” Barbara Karnes, a registered nurse, describes the dying experience based on her years of knowledge and caregiving in the hospice care field.
One to Three Months Prior to Death
Withdrawal
Decrease in eating habits
One to Two Weeks Prior to Death
Disorientation
Physical changes in:
Blood Pressure
Body Temperature
Increased Perspiration
Skin Color
Normal Breathing Patterns
One to Two Days, to Hours Prior to Death
A surge of energy may take place
Restlessness may increase
Breathing patterns become slower and more irregular
Congestion may be present
The eyes may be glassy looking or partially closed
The hands and feet may take on a purple cast
A person may be non-responsive
Contact Paradigm Health for more information and how our hospice care team can assist in assuring a comfortable and respectful hospice journey for you or your loved one.
“Death is as unique as the individual who is experiencing it and comes in its own time, in its own way.”
Barbara Karnes, hospice care nurse
Helpful Links
CICOA
Serving Central Indiana
Life Streams
Serving Madison, Grant and Delaware Counties
Area 5 Agency on Aging and Community Services Inc.
Serving Howard and Tipton County

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