New Studies in Palliative Care
http://thedianerehmshow.org/shows/2010-08-24/new-studies-palliative-care
Palliative care can be a powerful therapy for the pain and stress of serious illness. A new study shows it not only improves the quality of life, it actually extends it.
Guests
Dr. Diane Meier
Director, Center to Advance Palliative Care at The Mount Sinai School of Medicine in new York City.
Dr. Atul Gawande
Author, staff writer for New Yorker, surgeon at Brigham and Women’s Hospital and Associate Professor at Harvard Medical School and Harvard School of Public Health
Dr. Jennifer Temel
assistant professor of medicine at Harvard Medical School, an attending physician in thoracic oncology at Massachusetts General Hospital and lead author of the study of palliative care on terminal lung cancer patients.
Christina Tafe
palliative care nurse practitioner at the Lombardi Comprehensive Cancer Center at Georgetown University Hospital.
Comments
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I was only able to hear the first half hour of the show today; as usual, it was excellent. I have been a massage therapist for 20+ years, and the last 3 I've been able to offer massage in a hospital helping any patient who requests care, if they have a doctor's permission for it in their chart. Mostly I see post-partum mothers, happy but exhausted from the energy of bringing life into the world. But when I am able to participate in the reverse of this flow - when a person is exhausted from the effort of pain, illness; when their family also is dealing in this transition - this is the time when I know whatever comfort I can offer, can help in a way that all the medical tools cannot. Our hospital adopted massage as part of the Planetree program, a holistic approach to patient care, and I am very thankful to be a part of this practice as an independent contractor. I would mention that unfortunately, insurance generally does not cover this expense; it is out of pocket for the patient or family.
Hi Bette,
Your message makes me hurt for my mom that is experiencing this journey without any support that could ease her heart and mind and body. My mother lives toward the coast in North Carolina and has very little support. I am at a loss as how to help her (see my post earlier- pcvfatou). Are you aware of any resources that I might pass on to her?
Thank you for sharing your message.
Kendra
Thank you for focusing on the topic of palliative care. I am a retired clinical social worker and served on the Hospice Council of North Eastern Ohio in the late 70's. I was instrumental in developing Hospice of Medina County (Ohio) founded in 1980. Hospice of Medina County is now in the process of building an 18 bed inpatient unit. I am pleased that health care providers are moving in the direction of greater interest in helping people prepare for the dieing process. Helping people face their end in ways that promote closure, letting go, saying goodbye and preserving dignity are ever so valuable. However, I am saddened that so many years continue to pass with continued resistance from so many wonderful and well intentioned medical people. I hope that those who spoke on your program will continue their fine efforts to move our country forward in the area of Hospice and Palliative care. Surely those two wonderful services can work in conjunction with one another and improve care for all.
Lowell Nofziger, MSW
Hi Kendra,
My heart aches for you and your mom. My experience with my husband was hard and painful enough, even with the wonderful resources I had.
Take a look at these websites: http://www.getpalliativecare.org/
and http://www.capc.org/ CAPC is based at the Mount Sinai Medical Center in NYC. You might want to call & email Lisa Morgan & Sadia Choudhoury at CAPC: 212.201.2670 . You can say that I (Bette Kerr) suggested you call to see if they can help in any way. You may be able to find their direct phones or emails on the CAPC website. I hope you find something or someone helpful.
Bette
As a hospice RN for 4 years in a not for profit hospice, and certified by the National Hospice and Palliative Nurse Association, I need to respond to this comment. First and foremost the hospice nurse is there to promote comfort, safety and alleviation of symptoms with the least amount of side effects possible. The medications that we use, (yes, morphine and often antianxiety agents) are given at the smallest amounts needed to alleviate the symptoms of pain anxiety, delerium and dementia. Obviously you were not connected with a licensed hospice service. As for leaving a patient in their own excrement, not one of our professionals, from social worker to hospice aid would ever knowingly allow this to happen. I have often cleaned up patients or assisted families in doing so.
The patient's primary care physicin is always the prescribing physician, using the hospice medical directors (who are specialists in hospice care, geriatric care and end of life care) only to prescribe if the PCP is unavailable or deferrs to them. Nurses or any other "hospice care worker" can either deliver any medications or prescribe them without a physician order.
We also offer paliative treatments to our patients while a hospice patient. Often IVs, Blood transfusions, chemo, radiation are utilized to improve the patient's comfort and quality of life in their last days.
I am sorry that you had the above experience, but hopefully this will help others who are considering hospice care for themselves or a loved one.
We are there to help when no treaments are desired or offered. Hospice care definetly DOES NOT mean NO CARE.
Palliative care can be applied any time during a life-threatening illness, where hospice applies to the last six months of life; both are about creating the best quality of life possible.