How Hospice Supports Your Care Delivery at the Holidays

elderly hands resting on a lap in front of a Christmas tree

Written by Deb Gallaher, MBA, MSN, RN, NE-BC, CHPN

With the holiday season upon us, it’s worth noting that many care providers see an increase in family requests for serious illness support. It’s not a conversation anyone wants to have, especially around the holidays. That’s where a referral to hospice can help facilitate difficult decisions and meaningfully support the end-of-life journey. 

Signs and Symptoms of Health Decline at the Holidays

There are many reasons individuals appear to experience increased health decline at or after the holidays. A phenomenon called the “Christmas holiday effect” has been observed to elevate cardiac mortality around the holiday season, for example. 1  

While the causes of this are multifaceted, in general we see an increase in requests for hospice support following family gatherings at the holidays, due to a few common factors. For one, older adults who have been declining over time due a serious chronic illness may “hang on for the holiday” and take a sudden turn for the worse in the days or weeks after. Families also may become aware of the gravity of an illness as they spend time together.  

[action 1]

Regardless of the individual’s underlying health conditions, there are some common signs that the end of life may be near: 

  • Significant decrease in appetite and thirst 
  • Increased sleeping, sometimes for most of the day as well as at night 
  • Worsening mobility challenges 
  • Increased infections and/or wounds 
  • New or worsening incontinence 
  • Increased pain, nausea and/or vomiting 
  • Increased shortness of breath 
  • Less communicative 
  • Confusion, delirium or agitation 
  • In advanced stages of dying, a drop in temperature, blood pressure and color changes (blue or purple) to the hands or feet may occur and fluid accumulation in the throat (“a death rattle”) may be heard.

When to Refer to Hospice

Ideally, referring to hospice should happen sooner rather than later once a patient is eligible, to provide them more time with supportive care. Research shows that as many as 50% of hospice patients are enrolled for 18 days of care or less, even though eligible individuals can receive care for up to six months if certified by a physician. 2 

At Amedisys, our referral intake specialists can help determine next best steps to help determine if hospice is the right choice. Basic hospice eligibility criteria include:  

    • Physician-certified terminal illness, with six months or less to live if the disease runs its normal course.  
    • Patients are ready to stop treatment to cure their illness and elect the hospice benefit.  
    • Patient’s hospice provider is Medicare-approved.  

How Hospice Supports Your Care Delivery

As specialists in providing support for the end-of-life journey, hospice care providers like Amedisys know how to navigate the challenges facing both individuals and their families during this difficult time, and as a valuable resource, can help support your care delivery. 

Hospice care is a holistic model that offers a comprehensive, interdisciplinary approach to physical, emotional and spiritual support for those it treats. It focuses on comfort and quality of life, wherever the person calls home, with the following interventions: 

  • Pain and symptom management 
  • Help in developing personalized end-of-life goals 
  • Emotional and bereavement support for family members and caregivers 
  • 24/7 accessibility 
  • Support that reduces avoidable hospital admissions 
  • Cost-effective care, typically 100% covered by Medicare for eligible individuals 

Need Hospice Resources Today?

Even if you’re unsure if it’s time for hospice, we can guide you through individual situations and offer quick assistance and recommendations. Refer a patient to hospice today via one of our easy options and a specialist is available to help. 


Deb Gallaher, MBA, MSN, RN, NE-BC, CHPN, is a Senior Hospice Clinical Education Specialist for Amedisys. She has 10 years of experience in hospice and is passionate about sharing her insights on high-quality care.

 

Home health clinician providing care