Home Health Care Can Help Seniors With Loneliness and Social Isolation

By: Elizabeth Townsend, RN

People are social beings. With COVID-19 introducing social distancing guidelines and restrictions on visitations, social isolation and loneliness are increasing. A report referenced by JAMA discussed the need for solutions for social isolation and loneliness in older adults. There is significant documentation that social isolation and loneliness are related to a higher rate of major mental and physical illnesses, including:

  • Cardiovascular and cerebrovascular risks
  • More depression and anxiety
  • An increased risk of dementia

According to the National Institute on Aging, people who participate in worthwhile activities with others tend to live longer and have a sense of purpose.

Assessing seniors for isolation and loneliness

COVID-19 has made it difficult for seniors to participate in:

  • Social gatherings
  • Communal dining
  • Exercising in groups
  • Social programs at senior centers
  • Volunteering

Home health clinicians assess patients for social isolation and loneliness. Asking patients about their social needs is important to identify who needs assistance, easing isolation and loneliness. The home health agency provides tools or guidelines with questions for the clinicians to ask. Examples of questions to ask:

  1. Do you feel you have no friends or loved ones?
  2. Are you lonely?
  3. How are you staying active?

5 ways to relieve isolation and loneliness

After assessing and finding that your patient is suffering from social isolation, consult with their caregivers and healthcare team —specifically the agency’s social worker—to find ways to relieve their isolation. Daily Caregiving suggests some ways to help:

  1. Encourage a sense of purpose. Suggest activities such as knitting blankets and caps for newborns at a local hospital, making masks for healthcare workers or family members, or writing letters to their grandchildren to encourage them. Allow the patient to have a responsibility, such as taking care of a plant or dog. This would be giving them a meaningful purpose.
  2. Encourage interaction. Encourage interaction with others via phone, computer, or if in person, socially distant, wearing a mask.
  3. Encourage physical activity. Take Into account the patient’s physical ability. They can do gentle exercises such as walking, stair-climbing, yoga, or group exercises via computer. If they cannot get out of bed or are not able to walk, find appropriate activities. Consult with the physical therapy team who can provide resources for exercises for those with limitations.
  4. Assess the food they are eating. Encourage fiber-rich foods like fruit, vegetables, whole grains, and lean proteins. Consult with community services such as food banks, churches, or meal delivery services.
  5. Show them they are loved. Find ways to show that they are loved and needed. Listen to what they have to say. Encourage family members, if they are in the home also, to hug the patient and talk and listen to them.

Social workers can help seniors with social isolation and loneliness

Social workers can ensure that patients have access to available resources. Local churches may have “shut-in” outreach for those unable to leave their homes. They may provide phone calls, run errands, provide food baskets, and communicate by mail with the seniors. Local library programs have online programs and can arrange to have books available for the patient to check out. The social worker can also refer the patient to transportation programs that take seniors to doctor appointments.

Encourage virtual connections for seniors

Advancing States created a resource to help reduce social isolation and loneliness.

  1. If the patient can use a smartphone, show them how to google Earth National Park Tours so they can “visit” the parks and talk about what they saw with others via telephone or with you when you visit.
  2. Patients can meditate through Journey Meditation.
  3. Put the patient in contact with Well Connected by Covia, who will help them participate in virtual classes, conversations, and activities by phone and computer.

There are helplines for mental and emotional support, which include:

  1. Friendship Line by Institute on Aging- 1(800)971-0016
  2. Happy– a free app that provides emotional support 24/7
  3. National Alliance on Mental Illness Helpline- 1(800)950-6264
  4. Substance Abuse and Mental Health Services Administration National Helpline- 1(800)662-4357

COPD Patients: Doctors Calling For Earlier Hospice Referrals

By: Wilma Peterson, RN

According to the American Lung Association, Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in the United States. Living with the symptoms of COPD, such as difficulty in breathing, can induce stress for both the patient and the family. Due to this, Doctors are beginning to call for earlier hospice referrals for these patients with COPD. If elected early, the benefit of hospice care can assist with symptom management, prevent unnecessary hospitalizations, and help patients achieve a better quality of life. 

Patients with advanced COPD are eligible for hospice care, which is fully covered by Medicare, some private insurances, as well as assistance from Veterans Affairs. When hospice care is chosen early, patients have access to the appropriate care and medications, allowing for more restful periods and easier breathing. Identifying these factors early can relieve symptoms such as anxiety, panic, labored breathing, and intractable coughing that are uncontrolled with regular medications and traditional therapies.

Factors to consider when discussing the appropriateness of a hospice referral for a COPD patient include:

  1. The patient has a projected life expectancy of 6 months or less
  2. All therapies, including medications and rehabilitation, have been exhausted
  3. The patient has frequent emergency room visits and hospitalizations due to exacerbation of COPD

At this point, the patient is considered to be in the advanced stages of COPD, and the discussion for hospice and end-of-life care should begin.

Eight benefits of early hospice referral for those with COPD

Electing the hospice benefit early allows for the expertise of a focused team of professionals:

  • Physician
  • Nurses
  • Social worker
  • Chaplain
  • Ancillary services

Hospice services are available 24/7/365. The hospice care team will provide medical, emotional, psychological, and spiritual support to the patient and family. Here are eight benefits of early hospice referral:

  1. Early intervention. The earlier the hospice referral is made, the more time it allows the patient and their family to select the right hospice company and be a part of the care plan.
  2. Managed care. A physician leads the hospice care team and can order the appropriate medications and therapies and cater to an individualized care plan for each patient. 
  3. Skilled Nurses. A registered nurse will meet with the patient and family, and can admit the same day. The nurse will also reconcile all medications, put together a plan that focuses on managing symptoms, and provide relief of pain and respiratory distress. 
  4. Hospice Aides. Health aides assist with normal daily activities:
  • Washing
  • Grooming
  • Dressing
  • Ambulating safely
  • Other household chores, as needed
  1. Medical Social Worker. A social worker will support patients and families with accessing resources within the community, such as respite care, living arrangement and other services. 
  2. Chaplain. Clergy works with the patient and their family to support psychological and spiritual needs, assisting them through the end-of-life, grieving process or any other related needs.
  3. Ancillary services. Other ancillary services like physical therapy and occupational therapy, strengthen muscles to assist with safety and allow for a sense of independence.
  4. Respite Care. Allows time for self-care and rest, which can help with a change in attitude and mindset in caring for your loved one.

Living easier with hospice care

Early hospice referrals means early management of symptoms by:

  • Having the appropriate therapy and staff when needed
  • Avoiding the stress of emergency exacerbations and unnecessary hospital visits
  • Providing a more individualized approach to the patient and caregiver
  • Alleviating stress to allow time for future planning or ability to spend quality time 

Don’t wait, make the referral to hospice early. An early hospice referral can provide extra support for both the caregiver and the patient. If you or a loved one is struggling with COPD, consider the benefit of hospice services. 

Hospice: Keeping Loved Ones Home for the Holidays

The holidays can be a challenging and bittersweet time for those with a seriously-ill loved one. Electing the hospice benefit may seem like one more item on your to do list, but hospice can ease the burdens of facing a life-limiting illness. If a loved one has unmanageable symptoms, they could end up spending their holiday in the hospital, away from family and friends.

Springhill Hospice helps families manage their loved one’s pain and symptoms so they can spend the holidays in the comfort of home–whether that means in their own home, in a loved one’s home, or in a skilled nursing facility or assisted living facility that they’ve made their home.

Hospice Care in the Comfort of Your Home

Whether your loved one is being cared for at home or in a facility, the additional layer of support that hospice can provide can make all the difference. Hospice care can help manage complex symptoms of pulmonary disease, cancer, dementia, Parkinson’s, heart disease, stroke, liver or kidney disease.

Our interdisciplinary approach, which includes care from a nurse, aide, social worker, chaplain, medical director, and the patient’s primary care physician, is designed to support patients and their families physically, psychologically, and spiritually. With the assistance of this personalized care team and the guidance of the patient’s primary physician, your family can have the support necessary to keep your loved one comfortable and supported without unnecessary hospital visits or doctor appointments.

Springhill Hospice’s team is local and available 24 hours a day, 7 days a week, 365 days a year to provide care for our patients and for admissions.

Hospice can also provide necessary durable medical equipment, such as a hospital bed; medications related to the patient’s primary hospice diagnosis; and incontinence products and nutritional supplements. By utilizing hospice services, families have more time to enjoy the most meaningful moments of the holidays — time spent together with family.

Family & Caregiver Support this Holiday Season

With holidays comes stress, as time runs out to shop, run end-of-year errands, and attend special events. Combine that with caring for a seriously-ill loved one during these unprecedented times, and life can become overwhelming quickly.

Our hospice care extends beyond the patient. Springhill Hospice works closely with family members to assure they have the tools necessary to cope with stress or caregiver burnout surrounding what may be the final holiday with someone they love. In addition to scheduled visits, patients and their families will have access to a dedicated hospice nurse by phone who is available to answer your questions and dispatch a nurse to your home as needed.

Our team of chaplains and social workers collaborate to address patient and family members’ emotional, psychological and spiritual needs. They make certain our patients’ families have a plan for the holidays, so they can make the most of the holidays without piling up additional stress.

Caring for a loved one facing a terminal illness can be demanding, but it can also be incredibly fulfilling. Springhill Hospice can partner with you or your loved one’s facility to ensure everyone – patient and family alike – is supported and cared for this holiday season.

If you have a loved one with a life limiting illness, please contact us to learn more about how Springhill Hospice can help your family this holiday season, because home should be more than a holiday wish!

The Hospice Benefit for Veterans

Care at no cost to Veterans and their families.

Springhill Hospice collaborates with local VA agencies and programs to raise awareness about the benefit of hospice services for Veterans. As a Veteran, expenses for hospice-related services or enrolled veterans are covered in full.

We Honor Veterans Program

Springhill Hospice partners with the We Honor Veterans program to give veterans the best care possible. This program provides resources and training to meet the needs of our veteran patients and their families through respectful inquiry, compassionate listening, and grateful acknowledgement so that veterans can have a peaceful end-of-life experience.

VA Hospice Program Benefits

Hospice is a benefit that the VA offers to qualified Veterans who are in the final phase of their lives. This multi-disciplinary team approach helps Veterans live fully until they die. The VA also works very closely with community and home hospice agencies to provide care in the home. The VA hospice benefit includes:

  • Care available wherever you call home
  • No co-pay for hospice care
  • Medical equipment, medication and personal care supplies
  • Personalized pain and symptom management
  • Care coordinated with your doctors
  • Physical, occupational and other therapy services
  • Spiritual care and support
  • Volunteers with military experience (when available)
  • Ongoing grief counseling for patients and family

Veteran-To-Veteran Volunteer Program

Springhill Hospice’s Veteran-to-Veteran volunteer program pairs Veteran volunteers with hospice patients who are Veterans as well. Veteran volunteers have the ability to develop a unique connection with patients and their families through their common experiences and stories, establishing a strong relational bond.

How can Veteran Volunteers Help?

  • Reminisce or tell life stories
  • Educate and answer questions regarding Veteran benefits
  • Assist in pinning ceremonies, distribute certificates and help with other recognition events
  • Assist in replacing lost medals

Sepsis Awareness Month: Why Our Program Actually Works

By: Portia Wofford

Home health clinicians play an essential role in caring for patients who are:

  1. At risk of developing sepsis
  2. Recovering from sepsis or septic shock

Home health providers are vital in preventing hospital admissions and readmission among sepsis patients. According to the CDC, sepsis is the body’s extreme response to an infection. It is a potentially life-threatening medical emergency.

Many patients receiving home healthcare services have chronic medical conditions and comorbidities that put them at risk for infection, including COVID-19 and sepsis. According to the Global Sepsis Alliance, COVID-19 can cause sepsis. Research suggests that COVID-19 may lead to sepsis due to several reasons, including:

  • Direct viral invasion
  • Presence of a bacterial or viral co-co-infection
  • Age of the patient

According to Homecare Magazine, approximately 80% of people with COVID-19 will have a mild course and recover without hospitalization. The remaining 20% of patients with COVID-19 may develop sepsis and be admitted. Patients with severe illness will need home health care.

A study published in Medical Care by the National Institutes of Health (NIH) suggests that when strategically implemented, home health care can play an essential role in reducing hospital readmissions for patients recovering from sepsis. According to Home Health Care News, the study points out that sepsis survivors who were less likely to return to the hospital if they:

  1. Received a home health visit within 48 hours of hospital discharge
  2. Had at least one additional visit and
  3. Had physician visit within their first week of discharge

According to the findings, these interventions reduced 30-day all-cause readmissions by seven percentage points.

Home health clinicians are trained to monitor patients and identify signs and symptoms of sepsis. Additionally, they can teach patients and their caregivers how to prevent and recognize sepsis. According to research and estimates, rapid diagnosis and treatment could prevent 80% of sepsis deaths.

Home health care can contribute to early detection of sepsis

Early detection is critical. For each hour treatment initiation is delayed after diagnosis, the mortality rate increases 8%. Home health nurses can monitor and educate patients and their caregivers on signs and symptoms to report to include. Additionally, home healthcare agencies can provide screening tools that fill the gaps in identifying at-risk patients during transitions from inpatient to outpatient settings.

Home health provides case management for chronic comorbidities

  1. Some comorbidities like Type 2 Diabetes, chronic heart disease, and dementia were associated with sepsis risk in almost all infection types. Those with other chronic illnesses, cancer, and an impaired immune system are also at increased risk. Monitoring can help reduce risks.
  2. Post-discharge and follow-up visits, including telehealth visits, may provide positive intervention for post sepsis patients.
  3. Nurses can review and coordinate care to adjust medications, evaluate treatments and interventions, and refer for appropriate treatment.

When it comes to serious complications, our sepsis program effectively:

  • Prevents infections that can lead to sepsis
  • Recognizes sepsis symptoms before they become severe
  • Rapidly responds if sepsis symptoms occur by initiating appropriate treatments and referrals
  • Follows-up with care to ensure continued recovery

Springhill’s sepsis program promotes quality of care and improves outcomes for those at risk for developing or recovering from sepsis.

September is Healthy Aging Month

During Healthy Aging Month, we focus on celebrating the many positive aspects of aging. Here are some tips to incorporate in your daily routine that can lead to a healthier lifestyle, allowing you to live your life to the fullest.

  1. Exercise – Get moving and active on a daily basis!
  2. Socialize – Stay in touch and find safe ways to connect with friends and loved ones!
  3. Stay balanced – Try new methods such as yoga to reduce stress and improve your overall balance!
  4. Rest – It’s important to make sure you are getting a good, quality rest each night. 

These are important tips to keep in mind for all ages and stages of life. Not only this month, but from now on, remember to take care of yourself and those who surround you. Healthy aging starts with you and your health decisions. 

Common Hospice Qualifiers

For many people, the decision to receive hospice care is made following the diagnosis of a life-limiting illness. Even so, some families still question this decision. Here are some common Hospice qualifiers to help determine when it might be time to elect the hospice benefit. 

  • Falls
  • Frequent physician, ET and/or Hospital visits
  • Weight loss and or BMI < 22
  • Decline aggressive therapy or is not a candidate
  • Wounds
  • EF < 20%
  • NYHA Class IV symptoms at rest
  • Little or no response to Bronchodilators
  • Serum < 2.5
  • Dysphagia and/or aspiration pneumonia
  • Shortness of breath and/or o2 sat of 88% or less
  • Frequent injections
  • Edema
  • UTIs
  • Upper respiratory infections, bronchitis or pneumonia

If you or a loved one are experiencing any of these symptoms and have questions about our services at Springhill Hospice, please contact one of our office locations near you to speak with a staff member about these Hospice qualifiers.

Music Therpy Benefits in Hospice Care

A Music Therapy Case Study | Joshua Gilbert, MT-BC

Throughout life, song can positively affect us both physically and emotionally. It influences bodily functions that we believe are beyond our control, such as heart rate, blood pressure and release of the body’s natural pain relief chemicals. Music therapy offers significant benefits for patients, caregivers and families. We offer it as part of our hospice services.

In a case study conducted (by Joshua Gilbert) on the impact of music therapy over a four-month period, with an older adult in hospice care, results exhibited significant signs of improvement in the following categories:

  • Quality of life
  • Self-esteem
  • Emotional expression
  • Breathing patterns

Through involvement in music-based interventions, these improvements allowed the patient to benefit from music therapy during hospice care. The patient often smiled, laughed and made positive comments about the music. After participating in deep breathing exercises and harmonica playing, the patient’s breathing became deeper and less labored. Additionally, the patient developed increased confidence in improvising harmonica music, and more open about expressing her emotions surrounding death.

Despite patient status or level of consciousness, music therapists can console and comfort them through music. Research has shown hearing is the last outside sensation that registers with a dying patient. Let us help your loved one make this experience more soothing.

To read the full case study, please click here.

Bridging The Gap

Allow us to add another layer to the health care dynamic!

Springhill Hospice’s psycho-social and spiritual team have always had a thoughtful and innovative delivery of care. Our approach is designed to meet the psycho-social needs of patients, families, and loved ones of those facing health challenges, especially during unconventional medial care protocols.

We would like to highlight how these needs are met with our current or new patients, as well as offer these services to any other patient or family in need as part of our community outreach.

  • Anticipatory Grief Support
  • Complicated Grief Support
  • Supplemental support for patient and family members
  • Remote/Telehealth Visits through shared technology
  • Facilitate virtual communication with patient and/or family

Providing supportive care by making a referral to our Bridging The Gap program is easy and confidential. A Springhill Hospice highly qualified social worker or chaplain will reach out to and connect with the family member or loved one who could benefit from additional support.

Additional Supportive Care is just a phone call away! Please call (251) 725-1268 and ask to speak to our Bridging The Gap coordinator to make your referral.

Common Hospice Diagnoses

Springhill Hospice is here for you – 24/7/365.

Choosing Hospice is often a difficult decision. We help lead this conversation and can ease the anxiety of the transition from cure to comfort for patients who are appropriate for hospice care. If two or more of these potential indicators are present, hospice should be considered.

Common Hospice Diagnoses

End Stages of: Cancer, Heart Disease/CHF, Pulmonary Disease/COPD, Dementia/Alzheimer’s Disease, Neurological Disease/CVA, Renal Disease & Liver Disease.

If your loved one is requiring increased assistance with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, oral care, toileting, transferring to their bed/chair, walking, eating, etc.; this may be an indicator that hospice should be considered.

Additional indicators include:

  • Muscle Loss/Weakening or Weakness
  • Multiple Falls
  • Multiple ER Visits/Hospitalizations
  • Recurrent/Multiple Infections
  • Altered Mental Status
  • Unintentional Mental Status
  • Unintentional Weight Loss
  • Difficulty at Mealtime
  • Increasing Shortness of Breath
  • Multiple Medication/Frequent Medication Changes
  • Sleeping Longer/Napping More
  • Skin Breakdown/Wounds
  • Other Diagnoses that Contribute to Decline

If you have questions about the hospice benefit or when to elect your benefit, please contact Springhill Hospice at 251-725-1268 (Mobile) · 251-626-5895 (Baldwin).