Palliative Care: The Art of Listening

People often call us looking for help in caring for a loved one afflicted with a serious illness. The conversation often begins with, “My loved one is very sick but not ready for hospice.”

Until recently, the only help we could offer was to lend a sympathetic ear and provide some guidance as to available resources until the patient met the Medicare guidelines for hospice care. Unfortunately, this was an unsatisfactory introduction to end-of-life care.

Palliative care patient, Deborah Campbell, and Dr. Thomas Putnam, HCC Medical Director. Deborah values the “good care at home with caring doctors and nurses.”

Medical advances in the last 39 years are enabling people to live longer with illnesses that are now life-limiting rather than terminal, such as heart disease, cancer, lung disease and stroke. Thankfully, the practice of medicine has recognized the need to support this new and frail population by providing medical, social, emotional and spiritual care. Thus, it is known as palliative care.

Palliative care is the medical specialty that focuses on keeping a patient at home, comfortable, pain-free and fully in charge of their own healthcare decisions. HCC has been doing this for hospice patients for nearly 25 years, but palliative care now benefits very sick patients who may still be undergoing curative treatment. Hospice Chautauqua County is on the leading edge of this new field of medicine.

“Eric gets the best care and attention he’s ever gotten,” said Chandra Goodway, Eric Robbins’s mom. “And it’s not just Eric’s care. Both Eric and I are truly blessed to have Hospice working with us.”

People in need of palliative care are the sickest patients in our healthcare system. They often have multiple medical specialists involved in their care, sometimes in distantcities. They have the most emergency hospitalizations and doctor office visits. Their caregivers are stressed and frequently absent from work; there might be unpaid medical bills and unmet family responsibilities because of the time required to care for their loved one.

“By reducing emergency room visits, hospitalizations and office visits, palliative care is saving everyone time, money and frustration,” said Lynn Austin, LPN, Palliative Care Coordinator. “Everyone wins with palliative care.”

HCC’s Palliative Care Program provides care where the patient lives with round-the-clock access to physician, nurse, social work and spiritual care. “When we say our program is community-based, it means we make house calls,” said Dr. Thomas Putnam, Hospice Chautauqua County’s Medical Director.

A wealth of additional information is available to the treatment team when care is provided in the home. “Environmental, social and other influences can be observed on a home visit that otherwise might not surface in an office visit,” continued Dr. Putnam. “Safety, diet, pets, family dynamics, etc. can be considered and more effective treatment can be devised.”

Dr. Putnam, the only board-certified palliative care physician in Chautauqua County, currently directs both hospice and palliative programs at HCC. He is increasingly consulted by area physicians and is able to assist primary care physicians in coordinating other medical specialists.

“There is a certain inertia that sweeps a seriously ill patient through the medical system,” said Dr. Putnam. “This momentum is often driven by well-intended curative motivations but without enough consideration to the patient’s comfort and values. Palliative medicine hits the ‘pause button,’ in order to allow the patient to fully consider treatment options and restores them to the center of the decision process.”

HCC piloted its palliative program in 2012. Since then, the palliative program has received over 290 patient referrals. Four children are currently receiving our palliative care, and the number of participating physicians throughout the county continues to grow.

Area foundations have been supportive of the new palliative program, which is expected to be self-sufficient no later than 2018. Two local health insurance providers pay for palliative care, and a third underwriter is expected to provide coverage within a few months.

“Health care is on everyone`s mind and our delivery system struggles with the regulations they are forced to operate within. When a chronic health issue enters our life, we search for the options to allow us to enjoy the daily life we desire. The Chautauqua Region Community Foundation is pleased to assist with the Hospice Palliative Care Program, in hopes, that our friends who struggle with a chronic health issue will find the comfort they desire,” said Randy Sweeney, Chautauqua Region Community Foundation Executive Director.

Palliative care in Chautauqua County is improving the quality of healthcare, improving the health of our population and reducing the per capita cost of healthcare. If you or a loved one might benefit from palliative care, call our intake department at 338-0033 and speak to Lynn Austin, LPN, Palliative Care Coordinator.