Her mother had just died the day before. But Valerie* was hugging the doctors who cared for her mother. After all, they had done what the family wanted -- allow her mother to die pain free and in dignity.
"Palliative care benefits both patients and their families," according to Lauren Shaiova MD, Chief of the Department of Pain Medicine and Palliative Care at Metropolitan Hospital Center. "Although our main goal is patient comfort, we also support the family to get everyone involved in making medical decisions and choose treatments."
"Most people think that palliative care is the same as hospice care, "Dr. Shaiova adds. "Hospice is for terminally ill patients who are expected to live for about six months or less and are no longer seeking treatments to cure their illness. Palliative care is offered at hospices, but it can also be part of our treatment for patients with long-term chronic illness."
For example, Karen* has been a patient of Dr. Shaiova’s for 10 years and now sees her on an outpatient basis. She has a cancer history and multiple sclerosis. The pain she experienced made her feel hopeless and depressed.
"Before I met Dr. Shaiova, I could not cope with the pain," Karen says. "I know I will not be cured of multiple sclerosis, but my pain is under control. I am able to go out of the house and enjoy time with my family."
Valerie and Karen are among more than 200 patients and their families served by the Metropolitan Hospital palliative care team since the program started in September. Metropolitan is also the first public hospital in the country to establish a training fellowship in palliative care.
Across HHC 1,500 patients have benefited from the specialized services of palliative care teams. The program serves end of life patients as well as individuals suffering from chronic pain and stress of a serious illness, including cancer, sickle cell anemia, multiple sclerosis, AIDS, congestive heart failure and advanced dementia. The goal is to improve quality of life for patients and their families, and can be given at any point in an illness for patients who are hospitalized as well as in an outpatient basis.
During Fiscal Year 2008, HHC plans to invest nearly $3 million to develop palliative care programs for nine hospitals in the system as well as expanding the original programs at Bellevue and Coney Island Hospitals. The 11 palliative care teams at HHC consist of doctors with various specialties like psychiatry and internal medicine, nurses, psychologists, social workers and chaplains. In addition to providing obvious and humane care that benefits patients and families, the program is expected to be partially self-funding since it generally reduces ICU and other costs for those patients who choose it.
"Palliative care is a different way of thinking for doctors and patients," says Dr. Shaiova. "Healthcare professionals are trained to save lives. They view death as a failure. But, when the latest treatment or drug will not change the outcome or help the patient's quality of life, it is time for the palliative care team to step in and offer guidance and appropriate medical intervention."
* Not the patient's actual name
February 2008
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