In Depth: The palliative care movement

December 09, 2016 06:29 PM

As right to die laws gather support, another movement is also gaining traction, palliative care. The aim is to insure that those battling life threatening illnesses are empowered to get the type of care and support they want. That care can help keep them at home and out of the hospital. A Schenectady organization is on the leading edge of this movement.

At 47, Derek never thought he'd be facing his mortality. However, over the past seven years he's battled diabetes along with kidney and liver disease. Instead of creating lesson plans as a high school English teacher, he's struggled to stay healthy and out of the hospital. However, he has help thanks to Care Choices.

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It's a collaboration between Ellis Medicine’s palliative care and the Visiting Nurse Service of Northeastern New York.

"It's keeping me one, out of the hospital. Two, it's keeping me sane," he explained.

Care Choices provides in home Palliative Care for people dealing with a severe chronic, life threatening or terminal disease.

"You're adding quality, you're adding comfort. You're adding an opportunity to decide what matters most to you and how you want to play this out. It's your call. It's your life," noted Phil DiSorbo.

He heads up the program and defines "palliative care" as a multidisciplinary approach for patients with serious illness, focusing on physical and emotional symptom relief. He encourages its introduction early in the treatment process because it can help empower the patient and their family.

"If you have an advanced illness, palliative care should be integral to your care," advised DiSorbo.

"If I'm in severe pain, you know, and it's the middle of the night I can call the on-call nurse and something is done immediately," explained Derek.

WEB EXTRA: Doctor on palliative care

Good communication between provider, patient and family is key to insuring that what the patient defines as important is put into practice. That's the hallmark of the relationship between Derek and his long time palliative care nurse, Marsha Miller.

"I understand his disease process," Miller acknowledged. "He doesn't have to keep telling the same story over and over again."

WEB EXTRA: RN caring for patient on palliative care

Derek is among the 85 patients the program provides services for. It employs nurses, social workers and a chaplain.

"Fifty percent of that suffering is existential. It's the anxiety, it's the depression, it's the searching for meaning. It's the spiritual aspect. So if we're not taking care of those aspects, we're actually not doing palliative care," pointed out Michele Armstrong, a program coordinator for Care Choices.

WEB EXTRA: Palliative care program coordinator

While it won’t cure the illness, research finds palliative care can help people live longer.

"Doctors never like to give up hope. They never give up hope on their patients, but sometimes it's important to change what you hope for," noted Dr. Vacca, Care Choices Medical Director.

Rather than hope for cure, Dr. Vacca says doctors hope to keep their patients as symptom free as possible.

However, he notes curative and palliative care can and often are, provided together. That's important for doctor and patient alike, who may fear moving to palliative care means abandonment.

"Palliative care is anything but abandonment," assured Vacca. "Palliative care is an acceleration of care. It's an enhancement of care for people who have a special set of problems."

People like Derek. As long as he's qualifies for medical services from the VNS, Care Choices provide cares and insurance covers it.

WEB EXTRA: Palliative care educator

In the event a patient no longer qualifies, Care Choices follows up every 30 days for 90 days and can re-engage if a patient's conditions worsens.

"My father always said, ‘You try something. If they're able to provide you with what you need and meet your expectation, then you made the right choice,’ and so far, they've done both," noted Derek.

Anyone can request palliative care from Care Choices. Community Hospice in connection with St. Peter's Health Partners recently partnered with the VNA to offer similar services.

More information:
Care Choices, Palliative Care Program


Benita Zahn

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