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 visited with Bill and Bula Warlick. Mr. Warlick, who is his wife’s primary caregiver, spoke gratefully about having a volunteer (assigned through Transitions, one of three care programs at CHPC) to stay with Mrs. Warlick when he needs to be away for a while during the day. Sonya and the Warlicks 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 100 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.