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Home Health Case Study: Patient Transitions to Hospice Care

A Comprehensive Approach to Care

Profile

Service: Home Health & Hospice
Diagnosis: Stage III Buttocks Wound

An individual was admitted to Constellation’s Home Health service for treatment of a stage III buttocks wound and pain management. The registered nurse and occupational therapist each performed in-person assessments. Advanced care from our nurse practitioner allowed the patient to manage symptoms from the comfort of home.

Complete Care at Home Approach

Through questioning, the NP discovered that the caregivers were becoming overwhelmed with caring for their family member. This began conversations with the family and primary physician about available palliative/hospice services. The individual successfully transitioned to hospice care with Constellation, where he remained comfortable at home with his family until his passing.

Advanced Care

Advanced Care Icon

The NP—via virtual visit—
identified that the individual
was experiencing an
increase in pain, weight loss,
and advanced dementia
with hallucinations.

“We have been able to intervene with necessary interventions like ordering lab work, changing medications, even monitoring wounds and instructing caregivers during these video visits and have avoided several unnecessary trips to the emergency room.”

—Judy Walsh, Constellation’s Regional Director of Population Health

Key Outcomes

In collaboration with the patient’s family and home health team, the NP created a customized care plan including in-person and virtual visits.

The patient’s symptoms were managed and the team was able to comfortably transition the patient into hospice care with Constellation.

Contact Constellation

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