EVERY THURSDAY, WE'RE TAKING A
LOOK AT A HEALTH ISS
EVERY THURSDAY WE'VE
TAKEN A LOOK AT A HEALTH
AFFECTING MANY PEOPLE,
BREAKING DOWN THE
INFORMATION FOR YOU AND
TELLING YOU WHAT YOU
NEED TO KNOW TO KEEP YOU
HEALTHY.
DR. KALANI BRADY FROM
THE JOHN A. BURNS SCHOOL
OF MEDICINE JOINS US
WITH THIS WEEK'S TOPIC,
PALLIATIVE CARE.
GOOD MORNING.
I'M SURE A LOT OF
PEOPLE, MYSELF INCLUDED,
HAD NEVER HEARD OF
PALLIATIVE CARE.
CAN YOU TELL US WHAT
THAT IS.
THE PREVENTION AND
RELIEF OF SYMPTOMS OF
DISEASE.
IT'S NOT THE TREATMENT
OF THE DISEASE
SPECIFICALLY BUT IT'S
THE CARE OF THE PATIENT
WHILE THEY ARE SUFFERING
WITH THE DISEASE.
OKAY.
INTERESTING.
SO WHAT KIND OF EFFORTS
ARE PART OF GOOD
PALLIATIVE CARE?
MANY.
SYMPTOM MANAGEMENT IS
REALLY IMPORTANT.
IN A PATIENT WITH
CANCER, THEY OBVIOUSLY
MAY HAVE PAIN AND THAT
PAIN CONTROL IS
CONSIDERED PALLIATIVE
CARE.
LOT OF PATIENTS WITH
ENDSTAGE HEART DISEASE
HAVE CONGESTIVE HEART
FAILURE WHICH MEANS THAT
THE FLUID IN THEIR BODY
BACKS UP IN THEIR LUNGS
AND IT CAUSES TROUBLE
BREATHING.
WITH THOSE PATIENTS,
PALLIATIVE CARE IS
REMOVING THAT FLUID SO
THAT THEY CAN BREATHE
RELATIVELY NORMALLY AND
COMFORTABLY WHILE THEY
HAVE THIS HEART DISEASE
THAT MAY OR MAY NOT BE
TREATABLE.
OKAY.
SO ESSENTIALLY THEN IT'S
KIND OF LIKE TREATING
THE SIDE-EFFECTS OF SOME
OF THOSE DISEASES.
ABSOLUTELY.
OKAY, OKAY.
SO WHAT ARE SOME OF THE
CHALLENGES BECAUSE I'M
SURE THERE ARE SO MANY,
ESPECIALLY WHEN THERE
ARE SO MANY DIFFERENT
DISEASES?
THERE ARE.
REGULAR COMMUNICATION
BETWEEN THE DOCTORS AND
THE HEALTH CARE TEAM AND
THE PATIENT AND THEIR
FAMILY IS A REAL
CHALLENGE, ESPECIALLY IN
THIS ENVIRONMENT OF
REIMBURSEMENT.
THE GOAL IS TO SEE MORE
PATIENTS IN LESS TIME
BUT PALLIATIVE MEDICINE
HAS TO BE DONE SLOWLY
AND WITH REAL RESPECT
FOR THE PATIENT,
LISTENING TO THE
PATIENT, ADDRESSING
THEIR SPIRITUAL
CONCERNS, THEIR
PHYSICAL, EMOTIONAL
CONCERNS, DEVELOPING A
CARE PLAN WHICH THEY CAN
USE BECAUSE IT'S
DEVELOPED FOR THEM, BY
THEM, WHICH IS NOT THE
COOKIE CUTTER KIND OF
MEDICINE THAT WE
PRACTICE FOR TREATING
THE PRIMARY UNDER LYING
SERIOUS DISEASE.
OKAY.
SO WHAT ARE SOME OF
THE DIFFERENT REALMS OF
PALLIATIVE CARE?
I'M ASSUMING THERE'S SO
MANY NOW WITH ALL OF THE
DIFFERENT DISEASES,
RIGHT?
THERE ARE.
BUT THERE ARE SOME BASIC
TENANTS THAT GO ACROSS
TENETS THAT GO ACROSS
THE DISEASES.
CARE.
WHEN A PATIENTS THAT HAS
A SERIOUS DISEASE, THEY
MAY NEED
HOSPITALIZATION, THEY
MAY NEED REHAB
FACILITIES.
THEY MAY PROGRESS TO
SPECIALIST WILL
ORGANIZATION THE
HANDOFFS THAT OCCUR AT
EACH LEVEL WHEN THEY
SWITCH SITES OF CARE.
THAT'S A NEW DESCRIPTION
IN THE LAST TEN OR 20
YEARS OF MEDICINE IS
HANDOFFS.
IT MAKES SURE THAT
MEDICATIONS ARE
RECONCILED SO THAT
THERE'S NOT A CONFUSION
ABOUT MEDICATIONS, THAT
THE PATIENT THEMSELVES
FEELS EMPOWERED TO BE A
PARTNER IN THEIR OWN
CARE.
SO HANDOFFS IS ONE OF
THE BIG ONES.
CARE PLANS CONSISTENT
WITH THE VALUES AND
PREFERENCES OF THE
PATIENT IS REALLY THE
ULTIMATE GOAL.
RIGHT, OKAY.
WONDERFUL.
SO THAT'S WHAT
PALLIATIVE CARE IS.
SO HOW WOULD YOU KNOW IF
YOU WERE IN NEED OF
THIS?
HOW CAN YOU GET IN
CONTACT WITH SOMEBODY
AND HELP?
FIRST OF ALL, MANY
PRIMARY CARE PHYSICIANS
AND INTERNISTS ARE
TRAINED IN PALLIATIVE
CARE.
THEY MAY NOT HAVE GONE
THROUGH A FORMAL
PALLIATIVE CARE BUT THEY
KNOW THE TENETS IN
PALLIATIVE CARE.
IF THEY DON'T, THEY CAN
REFER YOU TO SOMEBODY
WHO IS A SPECIALIST.
SIMILARLY SPECIALISTS
ARE REQUIRED FOR TAKING
CARE OF PATIENTS THAT
HAVE MULTIPLE AXISES OF
PROBLEMS BECAUSE OF
THEIR SERIOUS ILLNESS.
WE TALK ABOUT YOU MAY
NEED AN ONCOLOGIST.
YOU MAY NEED A
CARDIOLOGIST, YOU MAY
NEED A NURSE
PRACTITIONER WHO CAN
HELP WITH EXTENSION OF
PHYSICIAN CARE.
YOU MAY NEED CLERGY
INVOLVED IN TAKING CARE
OF THE PATIENT BUT THE
PATIENT ALWAYS COMES
FIRST IN PALLIATIVE
CARE.
AWESOME.
GOOD TO KNOW.
THAT SOUNDS PERFECT.
THAT SOUNDS LIKE HOW IT
SHOULD BE.