Palliative Care
The Caldwell Partnership for Palliative Care, a consultative service, helps patients dealing with chronic and debilitating illnesses manage their symptoms and improve their quality of life. Unlike traditional hospice care, palliative care services are available to people who are not terminally ill, but are facing an illness that interferes with their ability to enjoy and cope with every day life. Palliative care is intended to give patients relief and comfort by relieving the pain, symptoms, and stress of serious illness. Palliative care is appropriate for anyone, at any age, at any point in the illness, including those seeking curative treatment, and is often used along with other treatments and therapies to help patients manage difficulties that come with chronic illness. Palliative care services are provided in patients’ homes, in long-term-care facilities, in hospitals, or in our outpatient clinic.
Palliative care is covered by Medicare/Medicaid and most private insurances. Because of the generosity of the community, our palliative care services are provided to anyone who needs it, regardless of ability to pay.
Palliative Care:
- Offers expert treatment of pain and other symptoms
- Encourages and assists with advance care planning (healthcare powers of attorney and living wills)
- Provides guidance with difficult treatment choices
- Provides spiritual care and emotional support to the patient and family
- Coordinates care with other healthcare providers
- Assists patient and family in planning for appropriate resources to meet patient needs
- Helps with navigating the healthcare system
Caldwell Partnership for Palliative Care is a collaborative effort by Caldwell Hospice and Palliative Care and Caldwell Memorial Hospital.
To learn more download our Palliative Care brochure.
In the Home
For patients unable to travel, Palliative Care is provided in the patient’s home. A nurse, nurse practitioner, or physician will make house calls. A social worker and chaplain are also available to visit, as needed.
In the Hospital
When a Palliative Care patient is hospitalized, the team will go to him or her, whether at Caldwell Memorial Hospital, Frye Regional Medical Center, Valdese Hospital, Grace Hospital, Catawba Valley Medical Center, or Watauga Medical Center. We also admit new Palliative Care patients who are hospitalized and provide palliative care in the hospital setting. When the patient is transferred home or to a facility, the team continues to follow him or her.
In Long-Term-Care Facilities
We at Caldwell Hospice and Palliative Care have made our Palliative Care services available to long-term-care facility residents who need relief from pain, symptoms, and stress of serious illness. Caldwell Hospice believes that the facility is “home” to many patients and that these patients have the right to receive palliative care when needed.
Skilled Nursing Facilities: Camelot Manor Nursing and Rehab Facility, College Pines Health and Rehabilitation Center, Conover Nursing and Rehabilitation Center, Gateway Rehabilitation and Healthcare, Lenoir HealthCare Center, Lutheran Home Hickory West, and Shaire Center.
Adult Care Homes: Brockford Inn, Carolina Oaks, Grandview Villa, Rose Hill Family Care Home, and Shaire Center.
Assisted Living Facilities: Lenoir Park.
In our Outpatient Clinic
Caldwell Hospice and Palliative Care operates its Palliative Care outpatient clinic two days per week inside the Forlines Patient Care Unit at the Robbins Center in Hudson. The clinic allows patients’ visits with our Palliative Care certified physician or adult nurse practitioner. The same care and attention the patient would receive at home can now take place in our comfortable clinic setting.
Caring HEARTS Journey
Caring HEARTS Journey helps children and young adults—from birth to age 21—who have a life-limiting illness by managing the emotional, spiritual, social, and physical needs of the patient and family members.
The Caring HEARTS Journey team—which includes a medical social worker, chaplain, counselor, nurse, and palliative care physician—works closely with the patient’s physician to maximize quality of life for each patient and family.
The program provides:
• Support—someone to listen—for patients, parents, and families
• Community referrals
• Assistance in developing goals of care, based on emotional, spiritual, and physical needs of patient and family
• A liaison between patients, parents, and service providers
• Consultative visits with our palliative care physician and nurse, as needed
A medical social worker or chaplain will either call the patient and family or visit them where the patient is staying (in the home or in one of the hospitals in Caldwell and surrounding counties). A palliative care physician and nurse are available to visit, as needed. A physician’s order is required before a child or young adult can receive the services, but anyone can make a referral, and the team will contact the patient’s physician about the service.
Palliative Care versus Hospice Care
Palliative Care is different from hospice care. Palliative Care is intended to help relieve the pain, symptoms, and stress of serious illness. It is appropriate for people of any age and at any point in an illness. It can be delivered along with care that is meant to cure the patient.
Hospice Care
- For patients with a life expectancy of six months or fewer
- Services by nurses, nurse practitioner, medical social workers, doctors, certified nursing assistants, chaplains, counselor, volunteers
- On-call staff available 24 hours a day
- Hands-on care
Palliative Care
- Anyone with a chronic or debilitating illness
- Services provided by a nurse, a nurse practitioner, and a doctor; social worker and chaplain available, as needed
- Services provided during business hours
- Consultative care and support
Palliative Care Stories
Palliative Care for Chronic Illness
(Published in Carelines, Spring 2009. Since publication, nurse practitioner Lori Dixon has joined our palliative care team and we have added our outpatient clinic.)
For a person living with congestive heart failure, lung disease, Parkinson’s disease, Alzheimer’s, etc., daily activities can be a problem. Preparing a meal, walking, or concentrating may be limited by pain or other symptoms. We recommend palliative care, a patient-and-family-centered program to improve quality of life by anticipating, preventing, and treating suffering.
Palliative care is not the same as hospice care. While hospice patients have an estimated six-month life expectancy, people who need palliative care are not dying. Caldwell Hospice and Palliative Care physician Dr. Thomas Ray says palliative care provides the hope that lets the patient respond effectively to health problems.
Finding the right treatment requires teamwork: Dr. Ray, CHPC nurse Sonya Triplett, the patient’s primary physician, the patient, and the patient’s family. If needed, they call in a medical social worker and a chaplain. The team manages the physical, emotional, and spiritual needs which accompany a serious illness.
Dr. Ray and Sonya see patients at home, in the hospital, or in long-term-care facilities. Working with their regular medical care providers, Sonya and Dr. Ray focus on relieving symptoms, soothing pain, and bringing comfort. Palliative care patients may continue to seek curative treatment for their illnesses, if they wish.
Sonya and Dr. Ray listen carefully for any mention of non-pain symptoms (anorexia, anxiety, fever, confusion, constipation, cough, diarrhea, dizziness, weakness, memory loss, nausea, sleep disorders, vomiting, etc.). Patients may not notice increased dizziness or persistent coughs, but Sonya and Dr. Ray may recognize them as strong issues in relieving pain. Palliative care patient John Scheno told Sonya during a visit that he had felt really bad a few weeks earlier, but he did not call her. She reminded Mr. Scheno that, as his palliative care nurse, she is responsible to him and is just a phone call away.
Regular palliative care visits are scheduled for once a month; during those visits, Sonya listens, checks prescriptions, takes blood pressure, and makes suggestions, as needed.
As Dr. Ray examined palliative care patient Irene Flannagan, they discussed the huge improvement in her condition since October 2007 when he admitted her to CHPC’s hospice program. She was very weak and unable to get out of bed. After a year of close care, Mrs. Flannagan began, with the aid of a walker, to walk short distances. Her condition improved enough that she transferred from hospice care to palliative care! “I have a bad day and a good day,” Mrs. Flannagan says, but “I told a lot of people that you did wonders for me.” Patients’ attending physicians are in charge of their treatment—Sonya and Dr. Ray consult with them. Sonya placed a call to Mrs. Flannagan’s doctor to discuss her cough and to ask that her prescription be refilled. Afterwards, Sonya reported that Mrs. Flannagan’s doctor would be calling her the following morning. This attention to teamwork is reassuring to patients and helps in treating their conditions.
Sonya and Bill and Bula Warlick discussed prescriptions and pain, as she arranged to check with Mrs. Warlick’s doctor prior to their next scheduled visit.
The interaction between patients and the palliative care team may be one of the best parts of the program. Mr. Warlick says, “All those people up there—whenever we call, they go out of their way to help.”
Sonya and Dr. Ray ask questions in a neighborly visit way: “So when you went to Wal-Mart, were you able to walk or did you use the wheelchair? What bargains did you find? And when did you begin to feel tired or out of breath?” “Are you eating better since your wife came home from the hospital? I know you missed her. And are you taking your meds regularly?”
The number of palliative care patients has ballooned from 60 a year ago to over 150 now. It is never too early to begin palliative care, even with curative treatment (radiation, etc.)—remember that palliative care is not hospice care.
Caldwell Hospice and Palliative Care and Caldwell Memorial Hospital work together in presenting the program to the community. Potential patients, family, friends, clergy, doctors, nurses, or social workers may call CHPC to make referrals.
