Palliative care is a new board certified specialty for physicians and Martha Jefferson Hospital is a pioneer in offering this type of care. Suzanne Hilton Smith, Chaplain for Palliative Care at Martha Jefferson, explains that Palliative care is care for the whole person, working to relieve suffering of all kinds: physical, spiritual, psychological. Its goal is to improve quality of life for people with chronic or advanced illness. It’s a team approach, including a specially trained physician, chaplain, and other hospital staff, and works to help the families of the patients, too.
Hospice care is different from Palliative care. It is provided near the end of life, when people are thought to have 6 months more or less to live. Palliative care can help then, also, but really focuses on care for people with chronic or progressive illness, people who are not terminally ill. It is offered at the same time as all other sorts of other medical treatment; people do not have to stop aggressive treatment or be near the end of life to benefit from palliative care.
A person’s doctor, who will continue to take care of them, asks for a palliative care consultation. Team members sit down with the patient and help her think about her needs and her goals, about what is most important or most distressing, They ask about symptoms, worries, spiritual struggles, anything that is causing distress. They help her and her family understand the medical situation, reviewing all the important facts and explaining choices. The team focuses on the whole person—not just the heart disease or the chronic pain. Improving communication is a big part of this: the team talks with all the doctors involved, with nurses, dieticians, physical therapists. The team arranges family conferences, spending a great deal of time with the patient and family, helping with all their concerns.
Many times the first goal is to control distressing physical symptoms. If we’re in pain or short of breath or nauseated, we can’t think about much else. So those come first. As symptoms begin to be controlled, people have all sorts of goals: they might ask for emotional help for their families, wanting their spouses or their grandchildren to be supported. They may want to arrange for help when they go home, to take stress off their loved ones. They may ask for religious or spiritual comfort as they struggle with sadness or anger. They may want to think about financial worries. They may want help in talking with their families about important things. So in a broad sense, people have unique goals to make their lives better.
Martha Jefferson Hospital is doing this type of care because this is really a logical extension of our Caring Tradition. We’ve always worked to provide sensitive, individualized care, and this team approach takes our high standard of care to a higher level. In the changing world of high-tech medicine, we’re emphasizing this new way of placing a cloak of comfort around people dealing with difficult times.
Any patient at Martha Jefferson may ask their doctor if palliative care might be helpful. For example, our palliative care doctor sometimes helps with pain after surgery so that people can start rehab and get back to normal life more quickly.
Dr. Lisa Illig, Martha Jeff’s palliative care specialist, and I are happy to speak to community groups, explaining this type of care in more detail. We want people to know what we have available.