The Patient Perspective

seasons changing

Seasonal Change: Part of the Patient Experience
By Acclivity Chief Innovation and Patient Advocacy Officer, Dianne Gray

For many, the end of summer signifies a long-awaited return to football season or for those with kids in the house,the end of August and early September can be a time for back-to-school shopping!

However, for those facing end of life and their caregivers, seasonal change can be an uncomfortable reminder of the passage of time and can add an under-layer of understandable sadness and anxiety.

How can we help these patients and their inner circle? First and foremost, it’s important to be mindful of the potential for seasonal affective disorder in the coming months. This can occur when a reduced level of sunlight affects an individual’s serotonin, a neurotransmitter that affects mood. Though most symptoms begin in the fall and continue into winter months, some individuals are affected in the spring and summer, too, which points to seasonal shift being involved in the manifestation of symptoms.

So what can we do to support our palliative care patients and their family members as they cope with seasonal change?

1. Ask about ritual. What has been the patient’s customary practices for fall? Were they excited about the season for any particular reason? Is there a way to replicate an environment that once used to bring cheer or a feeling of emotional connection? One social worker decorated the patient’s room in the colors of his favorite sports team. Another care team brought crisp, colorful leaves to a patient who desperately missed being in nature during the fall season.

2. Help the patient and family member increase access to the community, whatever that means to him or her. Darker, shorter days may mean fewer daylight hours for driving, social interaction and connection. Technology can be of significant assistance, too, when physical presence is not possible. Reliance on volunteers may increase during the fall and winter months, also.

3. Increase movement (supervised, if need be). Research supports movement and exercise as part of a wellness protocol and making time for movement and activity can be especially tough for caregivers throughout the coming months. They too need support and care.

4. Increase accessibility or availability of music or music therapy. Science supports music as a way to increase mood and a general sense of well-being.

5. Validate the patient’s feelings, understanding that seasonal change can indeed bring on feelings of sadness, even if they cannot be articulated.

Seasonal change, though not often discussed, can be a genuine part of the patient experience for those facing end of life and to be aware of its presence may help those you serve. As a palliative care physician and author Dr. Ira Byock so eloquently shared in his book The Four Things That Matter Most, “We must remember that, even in the 21st century, death is never really a medical event but a human and personal event. Dying is a defining feature, strange and mysterious as it remains, of living.”

Dianne Gray is Acclivity’s Chief Innovation & Patient Advocacy Officer: She’s also a 25-year hospice and palliative care expert, researcher, author, filmmaker, EOL doula & global keynote speaker. Dianne is on the boards of the Elisabeth Kubler-Ross Foundation & the International Children’s Palliative Care Network. She credits her mission & passion to being a 14-year caregiver for her son, who died of a long-term neurodegenerative disease. She still sits bedside with patients who inspire her daily.

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