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A Note to Our Friends on

Last week, we made some technical changes on the back end of Caring with Confidence to add some exciting new features, like our new mobile website. Unfortunately, we just came across one downside: If you follow us through your WordPress account and/or in the Reader, you’re going to stop receiving notifications about our new blog posts. But we can work together to fix that.

We truly respect the family we’ve built here at Caring with Confidence—especially our blogger friends in the community—and we hope that you’ll help us keep that relationship going. To ensure that you hear about all of our latest posts, we invite you to continue following us by entering your email address in the “Email Subscription” form located at the right side of each and every page at

If you already subscribe to us by email, you don’t have to do a thing: you’ll continue to receive email notifications about new posts just as you always have. And if you’re not sure, feel free to check by entering your address in the subscription form. If you receive a message that you’re already subscribed, then you’re all set!

Thank you for helping us keep our community together so that we can continue to support each other in the days, months, and years to come.

Blog Update

Some exciting new features are coming to Caring with Confidence! Notable changes include a mobile site which will automatically load when you access on your smartphone, as well as additional login options for commenting—like Google and Yahoo!—or you can continue to use your WordPress, Facebook, or Twitter account as you always have.

To enable this improved functionality, we’ll be moving to a new web host beginning today. During the transition, Caring with Confidence may become unavailable for anywhere from 24 to 48 hours. Once the transfer is complete, it may take some additional time to get our comment system back online.

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Compassionate transitions in hospice care and in nature

by Valerie Hartman

Yesterday was a beautiful day in Bucks County, Pennsylvania.

It was the first day of spring, and the sun was shining.  The white snow drops have been in bloom for over a week, weathering two temperature drops and a snowfall.  They remain tall and strong as I walk by and notice them in home gardens this week.  The snow drops are first in the sequence of blooming events that the avid gardener measures via nature’s timeline.  A stroll around the flower beds is like glancing at a wrist watch.  What I love the most about the snow drop is the flower’s constitution to rebirth right through the snow in winter.  They seem so relaxed about it too.  Just one tiny, pure white, fragile drop of closed flower petals, will hold your eye to such beauty against the backdrop of winter.  Stark and peaceful.

Many people are feeling the renewal of energy this week.  Even when physical energy is down, spiritual and emotional energy around this change of season can go up. Read more

Paperless practice: Going wireless in hospice care

By Terri Durkin, SLP and Maggie Vescovich, SLP

Often our patients, and their caregivers, are amazed at the computer devices we use while making our visits…and we thought you’d be interested in knowing the background for why we use them!

The switch from paper to electronic health records can be credited to President George Bush, who established the Office of the National Coordinator for Health Information Technology in 2004.  He set the goal of widespread electronic health records by the year 2014.  This means that you and most Americans will have electronic health records by next year.  So, in an ideal paperless world, what are the advantages of electronic health records? Read more

Promises to the dying: in hospice and in life, the need to be realistic

By Ron King

Live out your deepest devotion with the courage of remaining in the moment and choosing to love through each day with the best you have to give.

A friend of mine promised her husband that she would never marry again so they could be together forever because that was his wish and he was dying.  Three days later he died when he was 41 and she was 39.  Today she is 64 and still single.  No one can question the loyalty or sacrifice of another, but we do need to test our own readiness and ability to make final vows and keep them. Read more

That sticky ‘stage theory’ of grief

By Leanne Billiau

“Every one can master a grief but he that has it.”
-William Shakespeare

This week we re-post one of the most talked-about posts from the Caring with Confidence archives. 

Those of us who are passionate about hospice admire the ground-breaking work of Swiss American psychiatrist Elisabeth Kubler-Ross. She was part of the hospice movement and her work with the dying put the topics of death and grief on the table for many. Even though she studied people who were dying and the emotional impact of getting that kind of traumatic news, her theory is prevalent in pop culture as “The Five Stages of Grief”.

It is in our nature to try and make sense of our world. We attempt to create order out of chaos, and the world can feel very chaotic and out of control for those who are grieving. Read more

Why is my loved one so tired since we started hospice?

By Lorraine Thayer, CRNP

One of the questions I hear frequently as a nurse practitioner working in hospice is: “Why is my loved one sleeping so much since hospice came on board?”

Families question the pain medications or the hospice team’s suggestion that a patient be permitted to nap as they choose. Patients and families frequently focus on the symptom rather than its underlying cause. Many believe that a person’s strength is under his or her control, and feel that the patient is “giving up,” “not fighting,” or “not eating enough.” This is not the case. Read more

Grieving: Landmarks and milestones

By Leanne Billiau

Change does not come all at once, as we sometimes wish it would.  Instead, it happens in small bits and pieces, over time.  This is why it can be difficult to recognize the progress you are making along your grief journey.

Mrs. S had been married to her husband for 47 years and had always referred to him as her anchor.  When he died she said she felt lost at sea, drifting aimlessly.  She wanted to know where the landmarks were and how she would recognize the milestones on what she was afraid would be a long and perilous journey through grief. Read more

The gift of conversation in and before hospice

Whether or not you had an actual conversation with your loved one about their end-of-life wishes, here you are: a hospice caregiver. You probably never expected this job, and whether it is a joy, a duty, or a heart-wrenching, difficult task—or all three—it is probably a tad easier if you know that the hospice patient you care for chose this path.

The Conversation Project is a website, an on-line community, and an invaluable tool to help families have the sometimes uncomfortable discussion about their end-of-life wishes. Ideally, this conversation happens when everyone is well and not during a medical crisis. But realistically, even when all is well, no one really wants to talk about death or serious incapacitation. Read more