[KHTS] – When someone is diagnosed with a life-threatening illness, it can be a confusing and uncertain time. Both the family and the patient are overwhelmed with options and possible outcomes. That is why the palliative care program at Henry Mayo Newhall Memorial Hospital helps the patient put a proactive plan in place and works with the family when a crisis does occur.
What is Palliative Care?
Historically, palliative care was seen as the final step before hospice care, managing a patient’s symptoms and pain when they had a one year life expectancy.
But now the program a seeks a much more comprehensive approach, said Dee Rickett, nursing director for palliative care at Henry Mayo.
The team is made up of Medical Director Dr. Balbir Brar, board certified in palliative care; two nurses; a chaplain and a social worker.
The goal is to meet with patients and their families not long after a diagnosis and make sure that they understand all the options, including types of treatment, psychological services available, and their wishes for resuscitative or heroic measures.
According to a document provided by Rickett, palliative care covers the following services.
- Relief from pain, nausea, fatigue and dyspnea, as well as depression, in conjunction with other therapies to prolong life
- Assistance to families coping with distress of caring for a loved one during duration of treatment
- Life affirming encouragement
- Integrated psychological and spiritual care
- Support to help patients live as independently as possible for as long as possible
- Support to help families during their loved one’s illness and during bereavement
- Improved quality of life that positively influences the course of illness
- Emotional and spiritual support to patients and their families
- Emotional and spiritual support to providers and hospital staff
- Response to crises, assistance in resolution of ethical questions regarding care
- Contact with pastors, priests, rabbis, or other religious representatives
“Recent studies indicate that patients receiving palliative care from the point of diagnosis may live for years with one or in many cases multiple chronic diseases,” according to the document Rickett provided. “One of the most significant palliative care studies to date by Dr. Temel et al., 2010, displayed that patients who were provided palliative care from the time of diagnosis along with their curative treatment actually had less depression, had less aggressive end of life care, yet lived on average two to three months longer than patients who did not receive palliative care.”
Knowing What the Patient Wants
Palliative care staff try to avoid situations where the doctors and family are “really in a crisis moment and no one knows what the patient wanted,” Rickett said.
Because the palliative care program operates out of the Intensive Care Unit, Rickett and her team often don’t get the chance to meet with patients when they are diagnosed.
But while specialized doctors focus on treating each aspect of the patient’s condition, whether it be the lungs or kidneys, Rickett said, the palliative care doctor looks at the big picture, taking time to sit down with the patient and their family and explain things.
It gives the patient an opportunity to voice their opinions or ask questions, she said.
The desires are different for every patient. Some want every possible life-saving measure, while others would rather not be put on a ventilator or be hooked to multiple machines.
Rickett mentioned the story of one patient who came into Henry Mayo with a life-threatening condition.
At the time, he met with the palliative care team.
He recovered enough to go home for a time, but later returned to the Emergency Room.
This time, the doctors were preparing to put the patient on a ventilator, but the chaplain in the ICU was able to remind the doctors and family that the patient had asked not to be put on a ventilator, based on his previous meeting with palliative care.
Instead, the doctors focused on making the patient comfortable and allowed him to pass in peace, Rickett said.
“(Palliative care) provides the patient dignity and choice even when they cannot speak,” she said.
At this point, the palliative care program simply does not have enough staff to meet with very patient, but they recently received a substantial grant which will help them focus on providing more services and educating hospital staff, patients and the community about the benefits of palliative care.
To learn more about what Rickett and her team do on a day-to-day basis, click here.