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Comfort During Difficult Times

Words can fall short when we try to comfort friends, co-workers and neighbors who have lost a loved one or who are experiencing a devastating illness. And when the news hits close to home, grappling with personal grief can be overwhelming.

Palliative care can provide invaluable layers of comfort to patients and their families during the course of a major or incurable illness, according to Thinh Tran, M.D., Baptist Health’s Chief Medical and Quality Officer.  He knows first-hand.

“I just lost my father in December,” Dr. Tran says. “Palliative care was part of his care plan. We were able to really plan for the best care from the early stages of his deterioration. He passed on peacefully with the best care from the medical team and our family.”

Two months after that experience, Dr. Tran offers personal insights about the role of palliative care, especially at Baptist Health where patient- and family-centered care is etched into the mission statement.

What is palliative care?

“It’s not about end of life. Palliative care involves early intervention when there is a life-changing diagnosis,” Dr. Tran says. “If you have chronic pain, a career-ending injury or a major illness such as cancer, palliative care can help you manage the disease and set long-term health goals.”

The National Cancer Institute [1] defines palliative care as “comfort and care given to a patient who has a serious or life-threatening disease from the time of diagnosis and throughout the course of illness.”

At Baptist Health, an interdisciplinary specialized team of physicians, nurse practitioners, nurses, social workers and pastoral care counselors, are committed to enhancing the quality of life for patients during the stages of a serious or life-threatening illness, says Rose Allen, R.N., director of Bioethics & Palliative Care at Baptist Health.

“We’re here to sit. We’re here to listen,” she says. “It’s understanding their goals of care and redefining hope in many ways.”

How does palliative care differ from hospice care?

Palliative care provides comprehensive management of a patient’s physical, emotional, practical, cultural, and spiritual needs during a serious or life-threatening illness — and while curative treatments are offered, Ms. Allen says.

Hospice care is a type of palliative care offered specifically for those who may not have long to live and choose to discontinue curative treatment.

The National Cancer Institute draws a clear distinction between the two concepts:

  • Hospice care “focuses on caring, not curing,” with an emphasis on pain management, according to the Cancer Institute.
  • Palliative care includes caring and curing.  Palliative care can be introduced in the early stages of a disease, and a patient does not have to be terminally ill to receive this type of care. For example, cancer treatments continue to be delivered and re-evaluated during many stages of palliative care.
  • What are the specific features of palliative care?

    Patient and families can expect support in the following areas:

  • Goal-setting consultations to respect the cultural, ethical and medical wishes of the patient and family.
  • Spiritual support.
  • Individualized care based on recommendations from the patient’s physicians and specialists.
  • Symptom relief and pain management strategies.
  • Psychosocial support.
  • “Palliative care physicians are experienced at narcotic dosing; they can address pain and symptom control with a holistic approach,” says Zulmarie Ortiz [2], M.D., Ph.D., a palliative care specialist at Baptist Hospital. “It is a support system for both patient and family through difficult decision making. The patients’ wishes, as expressed through living wills or in conversations with their loved ones, become the goals of care. We also provide psychosocial, spiritual support as well as music therapy.”

    Have there been studies about the benefits of palliative care?

    Research studies have provided clear-cut evidence about the value of palliative care, Ms. Allen says. For example, a three-year study reported that metastatic lung cancer patients who received early palliative care lived longer, with “clinically meaningful improvements in quality of life and mood,” according to a published report in the New England Journal of Medicine.

    Studies have shown that a dedicated team manages patient pain in a more timely and effective manner and reduces re-admissions and ICU length of stay, according to Dr. Ortiz.

    Palliative care will also be an integral part of the Baptist Health’s  Miami Cancer Institute [3]. Scheduled to open in 2016, the Cancer Institute will be built on a firm commitment to patient- and family-centered care, Dr. Tran says.

    “Whether it’s curable or not, cancer can be a devastating diagnosis. That’s why, palliative care will be an integral and beneficial element of the Cancer Institute,” he says. “I have experienced the need and benefits of palliative care services for my father.  And I know first-hand how much compassion and care mean to patients and their families during difficult times.”