Many people are unfamiliar with the term “palliative care”—until someone close to them is at the end stage of life in the hospital, or very ill and in pain.
Palliative care is the comprehensive, compassionate care given to those with serious illness or who are dying. It includes pain relief, spiritual counseling, emotional support and more for the patient and his or her entire family.
It is a fully developed discipline of medicine to which St. Joseph Hoag Health is deeply committed. Several of its Orange County affiliated hospitals offer palliative care programs, including St. Joseph Orange, St. Jude, Mission Hospital, and Hoag, as well as St. Mary’s in Apple Valley.
With California’s Aid-in-Dying Bill (which allows doctor-assisted suicide for dying individuals who choose it) now law – it became effective June 9 – Orange County residents might want to explore the options that palliative care programs provide.
End of life care and comfort
“The goal of palliative care is to offer the best end-of-life care possible,” says Kevin Murphy, VP, Theology and Ethics at St. Joseph. “It offers a multidisciplinary approach, addressing the body, mind and spirit. Palliative care uses evidence-based techniques and approaches that help a patient at this stage of their life.”
Palliative care includes the whole family because everyone is affected. “End of life conversations are not easy, and palliative clinicians are skilled in having these conversations, and in facilitating advance care planning,” says Murphy. One example of a robust program could be a patient “life review” says Murphy, where a dying individual gets the chance to reflect on significant events in his or her life and integrate the last stage into the whole story for a sense of completion.
In the past, and even sometimes in the present, a terminal diagnosis has been received with fear or even silence. Sometimes families think it’s best to not even tell the patient, believing it could cause the patient to give up hope.
But when patients are told about their diagnosis, it’s the experience in palliative care that patients don’t lose hope, though they do go through a cycle of emotions. And there is a time when a dying patient will reach a level of acceptance. “That’s a process any human being can go through—and palliative care guides you through that process,” says Murphy.
In fact, he adds, patients who engage in this kind of palliative care actually live a longer life. “This is because body, mind, and spirit issues are getting addressed,” Murphy says. “When patients’ symptoms of pain or distress are addressed, they experience, peace, acceptance and relief.”
Dignity for the dying
Dr. Vincent Nguyen, Medical Director of the Hoag Palliative Care program, says his team addresses the unique needs of each patient and those of family members.
“We treat the patient holistically,” says Dr. Nguyen. “With the care we offer, we can improve the quality of life —and many cases we then prolong life —of patients.”
Dr. Nguyen’s team includes doctors, nurses and social workers with palliative care training. One of their key duties is to facilitate communication between the treating doctors, the family and patient, so that everyone is clear about the prognosis and treatment options. “People are afraid,” says Dr. Nguyen. “And they want doctors to be honest with them.”
Addressing fear is a major part of palliative care. “Whenever any of us gets news of a particular pathology we have and prognosis, anxieties and concerns arise,” says Murphy. “The goal of palliative care is to help patients express—and address—those concerns.”
“St. Joseph Health advocates for palliative care as the gold standard for end-of-life care,” he says.