What is palliative care?
“If you have a serious illness, talk to your doctor about palliative care.”
These words of advice, intended to increase public awareness, emerged during a recent interview with members of the palliative care team at Greenwich Hospital’s Stephen and Betsy Corman Center for Palliative Care.
The serious illnesses for which palliative care is available include cancer at any stage, heart failure, COPD, dementia, ALS, poststroke conditions, end-stage liver or kidney disease, any chronic debilitating disease, or neurological condition that compromises function.
Palliative care helps people who live with these illnesses cope with their new normal, such as coping with the need for dialysis.
The palliative care team, working in collaboration with a patient’s physician, provides compassionate treatment, pain relief, and emotional support for the patient and patient’s family.
During the interview, team members emphasized the important role palliative care plays in coordinating care, providing guidance with medical decision-making, and helping patients navigate the health care system.
“We’re there to help them put it together ... and ... figure out what their goals are,” said palliative care specialist Dr. Alberta Alickaj.
I was interviewing Alickaj; Jennifer Trocola, advanced practice registered nurse; Giesele Castronova, licensed clinical social worker; and palliative care chaplain Rabbi MJ Newman.
A palliative care team typically consists of board-certified physicians, advanced practice registered nurses (APRN), licensed clinical social workers (LCSW), and chaplains who offer spiritual guidance.
The team concept is an essential element in the holistic approach, which takes into account physical, psychological, social, and spiritual dimensions, and forms the core of palliative care. This multi-dimensional and interdisciplinary approach draws upon the hospice movement that gained momentum in the 1970’s, inspired by Dr. Cicely Saunders who opened St. Christopher’s Hospice in London in 1967.
Saunders, who began her career as a nurse in the 1940’s and became a physician in 1957, is considered to be the founder of the modern hospice movement. She coined the term “total pain” to describe her observation that the pain a patient experiences is not confined to the purely physical dimension, but encompasses the entire person, including family and social relationships.
Although palliative care has its origins in hospice, it must be clearly distinguished from hospice. The terms are not interchangeable. Hospice entails palliative care, but palliative care itself is not limited to the end-of-life care associated with hospice.
The erroneous belief that palliative care signifies terminal illness has kept people from choosing such care, and unfortunately makes some physicians reluctant to suggest it. This misconception needs to be countered.
Palliative care is not about endof-life. To the contrary, said Rabbi MJ, it’s about living longer. She cited research that shows palliative care extends the life of seriously ill persons, and enhances their quality of life.
At present, most of those in palliative care are referred while hospitalized. But as the program grows and evolves, the palliative care team hopes to better serve the community by reaching nonhospitalized seriously ill persons in the larger community and encouraging them to ask their doctors for a referral.
Castronova and Trocola pointed out that support from a palliative care team would help seriously ill persons better manage their symptoms at home and avoid hospitalization, or re-hospitalization.
“It’s never too early to talk about the goals of care,” said Alickaj, noting that the sooner a person enters palliative care, the more effective the care.
The palliative care team is currently engaged in an outreach effort to increase public awareness of the benefits to seriously ill persons and their families, so that more people will have the opportunity to take advantage of this care.
“We want to reach as many patients as we can to provide the benefits of palliative care to them and their families,” said Alickaj.
On Tuesday June 18, Alickaj will be the speaker at a public information program on palliative care. Participants will learn what palliative care is, how it differs from hospice care, what the team approach entails, and the range of services offered.
This program, sponsored by Greenwich Hospital, will take place in the hospital’s Noble Conference Center from noon to 1:30 p.m. and is free and open to all. To register, or learn more, call the Stephen and Betsy Corman Center for Palliative Care at 203-863-4625, or visit greenwichhospital.org/ events.