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Palliative Care Helps Patients Live Well With Chronic Illness

For patients who have been diagnosed with a serious or chronic illness, palliative care can help provide support and symptom relief. “All too often, when medical illness strikes, it tends to hijack our life,” said Devjit Roy, MD, MAS, FAAFP, CHCQM, Director of Palliative Medicine at Montefiore Nyack Hospital. “Palliative care helps a patient refocus their life from being centered on their illness, back to what is important to them. Our time and attention is for helping a person live better. We’re here to support people navigate through the uncertainties of illness.”

Palliative care is associated with a decreased number of hospitalizations, better symptom management, and an improved quality of life, according to Dr. Roy.

What is Palliative Care?
Palliative care takes a “whole person” approach in developing a personalized plan of care that meets the specific physical, mental. and social needs for both the patient and their family. This can include relief from pain, loss of appetite, stress, anxiety, nausea, constipation, decreased mobility. or other symptoms that are limiting their quality of life.

“For instance, if a person’s diabetes is causing debilitating nerve pain, we will use ‘out-of-the-box’ thinking to develop a plan that enables someone to achieve their goal,” Dr. Roy said. “Or if a person has worsening heart failure despite medical optimization, and their shortness of breath is causing recurrent hospitalizations, we work with the patient to help to manage their symptoms more comfortably at home.”

Recently, a patient no longer wanted to take any of their medications because the side effects were too potent. The family was also feeling caregiver fatigue. “We were able to develop a simple treatment plan for the patient that minimized side effects and provided an extra layer of support for the family to help manage burnout,” Dr. Roy said. “That patient felt more control of their life and is living much more happily.”

Common health conditions treated by the Palliative Care Team include cancer, congestive heart failure, kidney failure, chronic obstructive pulmonary disease, HIV/AIDS, and Alzheimer’s disease and other dementias. Palliative care is especially helpful for patients who have had more than three hospital admissions in one year, or who have frequent emergency room visits.

The Palliative Care Team includes palliative care doctors, nurses, social workers, pastoral care ministers, dieticians, volunteers, pharmacists, and other specialists. “It’s an entire multidisciplinary support system. We understand that this type of care takes time – we can give that time,” Dr. Roy said.

Palliative Care vs. Hospice
People often confuse palliative care with hospice care, Dr. Roy notes. While both focus on improving the person’s quality of life, palliative care is appropriate at any point in a patient’s illness and can be provided in conjunction with life-prolonging treatment. Additionally, the Palliative Care Team empowers the patient to identify important health and life goals, and works collaboratively with the team members, including the primary care provider, to develop an appropriate, patient-centered plan of care.

“Hospice is helpful when a person is expected to have less than six months to live,” Dr. Roy said. “All too often, the Palliative Care Team is consulted only at the end of life, which is why many people confuse the two. Palliative care has so much to offer people when they have many years left, to help them live those years to the fullest. We are here to help you understand your illness, identify and achieve important goals, and improve your overall quality of life.”

Getting Started with Palliative Care
Many patients are connected to the Palliative Care Team when they are in the hospital. But palliative care doesn’t end when you leave the hospital, said Katie Howell, RN, BSN, PCCN, Manager of Patient Experience at Montefiore Nyack Hospital. “We will visit you while you are in the hospital and we will continue to support you and your family upon discharge,” she said. “If you have questions at home, we are available all the time by phone or email, and we can facilitate virtual meetings with Facetime and Zoom. Our goal is to find out what matters most to you, and accommodate you as best we can, in the environment where you are most comfortable – usually at home.”

If your primary physician hasn’t already recommended palliative care and you are interested, Howell recommends that you ask your physician for a referral.