Sometimes, what a patient really needs is a little tender loving care.
Dr. Annie Khurana, a geriatrician at Banner Boswell Medical Center, is spearheading the development of a palliative care program at the hospital. She said the TLC such a program offers is not only peace of mind for the patients, but can also help extend their lives.
When a patient has a life-limiting or life-threatening illness they might need more holistic care, not just physical attention for afflictions like liver or heart disease, Khurana said.
“This is the patient who is suffering,” she said. “A lot of times, patients feel they have been heard, but they haven’t been listened to.”
Hospitals across the country have been adding programs in palliative care — which focuses on treating pain, minimizing side effects, coordinating care among doctors and ensuring the concerns of patients and their families are addressed — at a feverish pace. The field has expanded so rapidly that a majority of American hospitals now have palliative programs, to the delight of patients who say they’ve finally found relief and a sympathetic ear.
Palliative care has its roots in the 1970s, but was slow to grow. Several pieces of research helped to advance the cause, though, showing widespread untreated pain in hospitals and nursing homes and the positive impact palliative programs had on such patients. Hospital officials find such care shortens hospital stays and saves money.
Because of the population of the community around Boswell, Khurana said, many of its patients can benefit from palliative care, and patients appreciate having someone who holds their hand while listening to them, rather than just writing on a pad. The palliative team also can help patients address an issue that might seem small and may have been missed by their primary care doctor, even if the issue is as simple as the brightness of the sun bothering them.
“A lot of times, patients will have more satisfaction,” Khurana said.
In 2000, there were 658 palliative programs in hospitals, according to the Center to Advance Palliative Care, representing about one-quarter of American hospitals. By 2009, about 63 percent of hospitals had palliative teams, with a total of 1,568 programs recorded. The field is expected to continue growing as awareness and acceptance spreads, just in time to help Baby Boomers — the 78 million Americans born between 1946 and 1964 — as they move toward old age and begin developing more serious and life-threatening illnesses.
A palliative care team, like the one Khurana hopes to have at Boswell, consists of a psychologist, social worker, chaplain, a nurse, and maybe a dietitian if needed. Khurana said one goal is to advocate for the patient and make life easier for them.
Often, staff and patients are more focused on more aggressive treatments for their illness, which may or may not be a benefit to the patient, but it can be difficult for hospital staff to make the switch to more comfort care, Khurana said.
“There is staff that has been trained for that,” she added, explaining her goal is to have a full unit for comfort care or end-of-life care.
Dr. Diane Meier of Mount Sinai Medical Center in New York, who directs the Center to Advance Palliative Care, said one of the discipline’s greatest benefits is that it looks at the patient as a whole.
“Patients see a different person for every single part of their body or every problem. The patient as a whole person gets lost,” said Meier, who won a MacArthur fellowship for her palliative work. “The patient is a person, not a problem list, not a list of different organ systems with different problems, not a list of different diseases. So we end up serving in a quarterback role for the entire medical system.”