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[SIREN]
- A SERIOUS MEDICAL ILLNESS
CAN INTRUDE INTO ALL ASPECTS OF YOUR LIFE.
YOUR PRIMARY DOCTOR AND OTHER VA PROVIDERS
ARE USING THEIR PROFESSIONAL SKILLS AND MEDICAL TOOLS
TO FIGHT YOUR DISEASE.
BUT SOMETIMES THE COMPLICATIONS CAN SEEM OVERWHELMING.
- YEAH, I MEAN, THEY HAD ME IN ICU
FOR LIKE ALMOST 2 WEEKS.
AND NOTHING BUT NEEDLES AND PINS IN ME.
I COULDN'T GET OUT OF BED, I COULDN'T DO NOTHING.
- SYMPTOMS OF YOUR ILLNESS MAY BE MULTIPLYING,
CAUSING PAIN AND SUFFERING.
THE STRESS IS FELT BY EVERY MEMBER OF YOUR FAMILY.
YOU MIGHT BE SEEING MORE MEDICAL SPECIALISTS.
BUT YOU STILL HAVE UNANSWERED QUESTIONS
ABOUT YOUR TREATMENTS, AND WHAT LIES AHEAD.
- SOMEBODY SAID, WELL, YOU LOOK INTO THIS,
SEE WHAT THEY COULD DO FOR YOU.
SO THEY ACCEPTED ME. AND, YOU KNOW, I'M GLAD THEY DID.
WISH
THAT COORDINATES YOUR CARE; GIVES YOU OPTIONS,
AND RELIEVES YOUR SUFFERING,
EVEN WHILE YOUR USUAL MEDICAL TEAM
CONTINUES TO TREAT YOUR DISEASE.
THAT SERVICE HAS A NAME,
AND IT'S CALLED PALLIATIVE CARE.
- I WOULD TELL THEM, FIRST OF ALL,
HOSPICE AND PALLIATIVE CARE IS OUTSTANDING, VERY.
AND, YOU KNOW, THEY DID ALL THEY COULD FOR ME,
AND I SEE WHAT THEY DO FOR ALL THE VETERANS.
- PALLIATIVE CARE HAS BECOME A MAJOR COMMITMENT
ACROSS THE VA HEALTH SYSTEM,
AND PART OF EVERY ENROLLED VETERAN'S
UNIFORMED BENEFITS PACKAGE.
- WE CAN BE A SOURCE OF CONTINUITY
FOR PATIENTS THAT ARE OFTEN IN A VERY COMPLICATED HEALTH SYSTEM
WITH LOTS OF DOCTORS GIVING OPINIONS,
AND LOTS OF COMPLICATED DECISIONS TO BE MADE.
WE COULD SERVE AS AN ADVOCATE FOR THOSE PATIENTS.
THERE'S CONSISTENCY WITH THE SUPPORT THAT WE CAN GIVE THEM
AND FOLLOW THEM IN SO MANY DIFFERENT SIGHTS OF CARE.
TIONS,
WE CAN FOLLOW THOSE PATIENTS IN THE OUTPATIENT SETTING
AS WELL AS INTO INTENSIVE CARE UNITS,
AND THEN INTO PERHAPS SETTINGS OF LONG-TERM CARE
LIKE OUR HOSPICE AND PALLIATIVE CARE UNIT.
BUT REALLY WHAT WE'RE TALKING ABOUT IS GOOD, HOLISTIC
COMPREHENSIVE CARE TO ADDRESS THE NEEDS OF PATIENTS
THROUGHOUT THE COURSE OF A CHRONIC ILLNESS
THAT MAY EVENTUALLY RESULT IN DEATH,
BUT HAVE NEEDS THROUGHOUT THE COURSE OF THEIR ILLNESS.
- PALLIATIVE CARE IS A SPECIALIZED MEDICAL SERVICE
DESIGNED TO COMPLEMENT OTHER MEDICAL TREATMENT APPROACHES,
WHILE ZEROING IN ON HOW SERIOUS ILLNESS AFFECTS YOU
IT EMPHASIZES COMFORT, COPING,
AND MAKING THE QUALITY OF YOUR LIFE
THE BEST IT CAN BE.
- PRETTY MUCH EVERYTHING WE DO IN PALLIATIVE CARE
FEEDS OFF OF THE GOALS OF THE PATIENT.
WHAT ARE THEIR GOALS FOR CARE?
PALLIATIVE CARE IS NOT TYPICALLY GEARED TOWARDS CURE.
IT DOESN'T MEAN THAT IT CAN'T BE GIVEN SIMULTANEOUSLY
TO THE PURSUIT OF CURE.
BUT IT IS USUALLY FOCUSED ON COMFORT MEASURES,
AND THAT INVOLVES ALL THOSE ASPECTS I TALKED ABOUT
WITH PERHAPS A CHAPLAIN, MAYBE A SOCIAL WORKER,
CERTAINLY A NURSE AND PHYSICIAN,
AND PROBABLY MANY OTHERS
AND TRYING TO FIND OUT HOW CAN WE HELP THAT VETERAN ACHIEVE THEIR GOALS.
AND NUMBER ONE ON MY JOB DESCRIPTION IS RELIEF OF SUFFERING.
AND HELPING VETERANS TO BE MORE COMFORTABLE.
AND WHEN THEY'RE MORE COMFORTABLE,
THE FAMILY IS GENERALLY MORE COMFORTABLE.
- PALLIATIVE CARE LOOKS AT WHAT THE VETERAN WANTS.
WHAT QUALITY OF LIFE DO THEY WANT.
WHAT ARE THEIR EXPECTATIONS.
HOW DO THEY WANT-- HOW DO THEY FORESEE THEIR FUTURE.
IT'S MORE OF A HOLISTIC, LOOKING AT MIND, BODY AND SOUL.
- DEFINITELY AGREE THAT PALLIATIVE CARE
IS A MIX OF GOOD MEDICINE
AND GOOD HUMANISTIC CARE.
- HOW DO YOU KNOW IF PALLIATIVE CARE
COULD HELP YOUR SITUATION?
ACTUALLY, PALLIATIVE CARE
SHOULD BE A PART OF YOUR MEDICAL CARE
WHEN ANY SERIOUS ILLNESS BEGINS TO HAVE
LIFE.
IT'S THERE FOR PEOPLE WHO HAVE BEEN DIAGNOSED WITH CANCER,
E,
OR DEMENTIAS, SUCH AS ALZHEIMER'S.
IF YOU JUST FEEL LIKE YOU DON'T KNOW WHERE TO TURN NEXT,
THAT MIGHT BE THE TIME TO TURN TO PALLIATIVE CARE.
- SO I THINK THE STEREOTYPE OF PALLIATIVE CARE
IS THAT WE'RE GOING
E.
AND THE SOURCE OF CARE THAT WE'RE PROVIDING
ARE AGGRESSIVE SYMPTOM MANAGEMENT, AGGRESSIVE PAIN CONTROL,
AGGRESSIVE NAUSEA AND VOMITING CONTROL,
MAKING SURE CONSTIPATION AND DYSPNEA ARE WELL TENDED TO,
SO THAT PATIENTS HAVE THE ABILITY TO INTERACT WITH THEIR FAMILY
AND HAVE THE MOST QUALITY OF LIFE AT THE END OF LIFE,
OR QUALITY OF LIFE THROUGHOUT THE TREATMENT OF AN ILLNESS.
- PALLIATIVE CARE IS PROVIDED
BY A SPECIALLY TRAINED TEAM OF HEALTH PROFESSIONALS.
IN VA, THAT TEAM INCLUDES A DOCTOR, A NURSE,
A SOCIAL WORKER, A CHAPLAIN,
AND A PSYCHOLOGIST OR MENTAL HEALTH PROFESSIONAL.
THEY MAY BE COMPLEMENTED, IN SOME CASES,
BY PERSONAL CARE AIDES, PHARMACISTS,
VOLUNTEERS OR OTHER PROFESSIONALS.
THIS TEAM APPROACH MANAGES THE COMPLEXITIES
LLNESS
INCLUDING PHYSICAL, EMOTIONAL, SPIRITUAL,
AND PRACTICAL ISSUES.
- SO MAYBE ONE WAY WOULD BE TO DESCRIBE
HOW I INTRODUCE THE TEAM WHEN I COME INTO A ROOM
FOR THE FIRST TIME AND MEET A PATIENT.
SO I SAY, WE'RE THE PALLIATIVE CARE TEAM.
WE'RE HERE TO SEE PATIENTS IN THE HOSPITAL WHO HAVE SERIOUS ILLNESSES,
AND WE ARE HERE TO BE YOUR ADVOCATES IN MANY WAYS.
WE WANT TO MAKE SURE THAT ALL OF YOUR SYMPTOMS ARE ADDRESSED,
AND THAT IS INCLUDING PAIN, BUT ALSO NAUSEA,
CONSTIPATION, ANXIETY,
ANY SADNESS YOU MIGHT FEEL.
IT'S ALSO TO MAKE SURE THAT YOUR VOICE IS BEING HEARD
AND LASTLY, WE REALLY WANT TO HELP GIVE YOU SUPPORT.
AND THE SUPPORT WE WANT TO GIVE YOU IS TO HELP
MAKE SURE THAT YOU ARE HAPPY AND FEEL SAFE
ONCE YOU LEAVE THE HOSPITAL,
BUT ALSO TO MAKE SURE YOU HAVE THE PSYCHOLOGICAL SUPPORT THAT YOU MIGHT NEED
AS WELL AS THE SPIRITUAL SUPPORT.
- TYPICALLY, PALLIATIVE CARE PROFESSIONALS
ARE ASKED BY YOUR PRIMARY CARE PHYSICIAN
TO TALK WITH YOU ABOUT WHAT MIGHT MAKE YOU FEEL MORE COMFORTABLE,
AND THEN MAKE RECOMMENDATIONS FOR ACHIEVING THAT GOAL.
CARE CAN BE PROVIDED ON A SPECIAL PALLIATIVE CARE UNIT
IN A HOSPITAL OR NURSING FACILITY,
OR HEALTHCARE PROVIDERS MAY COME TO YOUR HOME.
- WE ARE VERY MUCH PATIENT-FOCUSED;
THAT WE WANT TO KNOW WHAT'S IMPORTANT FOR THE PATIENT.
WHAT ARE THE PATIENT'S GOALS, WHAT ARE THE FAMILY'S GOALS.
HOW CAN WE DESIGN A TREATMENT PLAN
THAT'S GOING TO HELP THE PATIENT AND THE FAMILY
TO MEET THOSE GOALS.
- HOSPICE IS THE PART OF PALLIATIVE CARE
THAT OFFERS HIGHLY SPECIALIZED TREATMENT
WHEN LIFE EXPECTANCY MIGHT BE MEASURED
IN MONTHS RATHER THAN YEARS.
IF YOUR DOCTOR SUGGESTS HOSPICE,
IT MAY BE BECAUSE YOU NEED EXTRA HELP
IN LIVING WITH AN ILLNESS THAT HAS BECOME MORE ADVANCED.
VA ALSO ASSISTS WITH ARRANGING BEREAVEMENT SERVICES,
FOR SURVIVING FAMILY MEMBERS,
WHICH CAN BE OF GREAT HELP TO YOUR LOVED ONES.
- HOSPICE CARE DOESN'T JUST HELP THE VETERAN,
IT HELPS THE VETERAN'S FAMILY.
THE ABILITY TO INTERACT, TO GIVE THE FAMILY A BREAK,
TO GIVE THEM A CHANCE TO TAKE A DEEP BREATH
AND KNOW THAT THERE'S SOMEBODY ELSE THERE THAT CARES.
THAT'S SOMETHING EVERYBODY NEEDS.
THE SENSE OF SELF-WORTH THAT'S GIVEN TO THEM.
THE SENSE OF NOT BEING A BURDEN.
THAT'S HUGE. HOSPICE HAS THAT CAPABILITY.
- I COULDN'T TAKE CARE OF MYSELF,
AND BECAUSE I HAD NO HELP ALSO, LIKE HER, I HAD NO HELP.
AND I TRIED, BUT IT DIDN'T WORK OUT.
MY BLOOD PRESSURE WAS VERY HIGH WITH THE STRESS,
AND I'M MUCH BETTER THAN I WAS.
- I USE MY FATHER AS AN EXAMPLE.
WITHOUT THAT RESOURCE,
I FIRMLY BELIEVE HE WOULD HAVE DIED SOONER,
AND HE WOULD HAVE DIED WITH LESS DIGNITY.
- ALL THE PEOPLE WERE HERE, ALL THE NURSES, DOCTORS,
ASSISTANTS, EVERYBODY, AND NOW EVEN A SOCIAL WORKER,
THEY'RE BEAUTIFUL PEOPLE.
THEY WENT OUT OF THEIR WAY TO HELP ME.
THIS IS MY FELLOW VETS.
I FEEL A LOT MORE COMFORTABLE AROUND THEM.
YOU KNOW. AND I SAID IF I WANT TO GO,
THIS IS THE PLACE I WANT TO GO.
I WAS JUST AFRAID IF I'D LEFT HERE,
YOU KNOW, I WOULDN'T HAVE NOTHING.
LIKE, JUST...YOU KNOW, THIS IS LIKE MY HOME.
MY REAL HOME.
- WE ACTUALLY TRY TO PROMOTE QUALITY OF LIFE UNTIL DEATH.
SO THIS IS NOT YOUR TYPICAL UNIT WHERE YOU COME AND PEOPLE ARE--
IT'S QUIET AND EVERYBODY HAS, THEY'RE IN THEIR ROOM.
WE TRY TO HAVE EVERYBODY IN THE DAY ROOM DAILY,
WE INTERACT WITH THEM, THE FAMILIES ARE HERE.
AND WE REALLY ENJOY THE FAMILIES TO BE A PART OF WHAT GOES ON HERE,
AND TO REALLY MAKE THE FAMILIES PART OF OUR FAMILY.
AND WE ALWAYS SAY THAT, NOW YOU'RE PART OF OUR FAMILY HERE ON 7B.
- IT'S BEEN SO GOOD FOR HIM.
HE WAS DYING SO HORRIBLY WHEN HE WAS HOME.
I MEAN, HE WAS IN FOUR HOSPITALS BACK AND FORTH
AND HOOKED UP TO ALL KINDS OF THINGS.
HERE, I DON'T KNOW WHAT THEY'RE DOING,
BUT IT'S LIKE A MIRACLE.
HE'S BEEN REALLY MUCH, MUCH BETTER.
AND HE CAN AT LEAST FUNCTION AND BE A LITTLE HAPPY, YOU KNOW.
AND THAT'S-- IT'S REALLY LIKE A MIRACLE.
- AND I THINK THE GIFT
THAT HOSPICE HAS WITH OTHERS
IS TO SAY, WE ARE WILLING
TO BE WITH YOU, EVEN IN YOUR FEAR.
WE ARE WILLING TO TALK ABOUT THE THINGS
THAT NO ONE ELSE WANTS TO TALK TO YOU ABOUT.
WE ARE WILLING TO BE WITH YOU AT THIS TIME.
AND THE SURPRISE OF ALL OF THAT;
THE OUTCOME OF ALL OF THAT
OFTEN IS...
THAT PEOPLE ARE NO LONGER AFRAID.
AND THEY OPEN UP.
- VA PALLIATIVE CARE TEAMS
HAVE IMPROVED THE LIVES OF MANY VETERAN PATIENTS AND THEIR FAMILIES;
ADJUSTING PAIN MEDICATIONS,
SETTING UP HOME HEALTHCARE FOR VETERANS WHO LIVE IN RURAL AREAS,
AND HELPING TO ARRANGE IN-PATIENT HOSPICE CARE
FOR VETERANS UNABLE TO REMAIN AT HOME.
- WHAT COULD WE DO BETTER IN TERMS OF YOUR CARE?
WHAT COULD WE WORK ON?
- THE ACTUAL CARE I'VE RECEIVED,
I REALLY-- I CAN'T THINK OF ANY.
AS I SAID, MY EXPERIENCE HAS BEEN COMPLETELY POSITIVE
CTORS
AND AGAIN, EVERYBODY'S VERY KIND.
THEIR CONCERN WAS WITH WHAT YOU'RE DOING,
THAT YOU KEEP DOING THINGS, YOU KNOW,
WALK AROUND AND HAVE SOME ACTIVITIES.
AND JUST, REALLY JUST POSITIVE ALL THE WAY AROUND.
- WE USED TO SEE THE WIFE COME HERE EVERY DAY,
DRIVING 60 MILES, JUST BECAUSE SHE DIDN'T HAVE THE TRUST
IN WHAT THE CARE WE PROVIDE, WHAT WE CAN DO FOR THE VETERAN.
BUT OVER A PERIOD OF TWO WEEKS,
SHE STARTED COMING LESS AND LESS.
AND NOT THAT-- WE WANT HER TO BE INTERACTIVE,
AND I PICKED UP THE PHONE AND CALLED,
IS THERE SOMETHING THAT I CAN HELP,
E.
HER ANSWER WAS SIMPLE AND SWEET.
SHE SAID, I TRUST YOU GUYS NOW.
YOU PROVIDE A GOOD CARE.
I DON'T HAVE TO BE THERE EVERY DAY.
- VA IS OFFERING THESE SERVICES
BECAUSE WE BELIEVE IT CAN HELP VETERANS
AND THEIR FAMILY MEMBERS BETTER COPE WITH SERIOUS ILLNESS
AND END OF LIFE CARE ISSUES.
- I COME HERE AND THEN I SEE HIM AND I'M HAPPY THAT HE'S HAPPY,
YOU KNOW.
- IT'S A NEW AND IMPORTANT PART OF OUR HEALTHCARE RESOURCES
WE OFFER FOR VETERANS.
- IT GAVE ME GREAT PLEASURE TO KNOW THAT THESE ARE VETS
AND THEY DO A GREAT DEAL FOR OUR COUNTRY,
AND I CAN DO SOMETHING FOR THEM IN RETURN BY HELPING THEM.
- I HOPE AGAIN TO SEE MORE PATIENTS
TOWARDS THE BEGINNINGS OF THEIR ILLNESSES
AND BECOME ADVOCATES FOR THEM
ACROSS THE SPAN
- IT'S SOMETHING MUCH MORE THAN JUST MEDICAL CARE.
YEAH.
- THE DAY WE CAME IN, THERE WAS A PLAQUE
SAYING, "WELCOME JOHN R. MALLOY,
AND THANK YOU FOR YOUR SERVICE."
AND I KNEW THAT WE BELONGED HERE.
WE REALLY DID.
- HERE'S WHAT YOU CAN DO TO LEARN MORE ABOUT PALLIATIVE CARE.
ASK YOUR DOCTOR ABOUT IT.
IF YOU THINK IT MIGHT BE HELPFUL,
LET THE PALLIATIVE CARE TEAM COME AND TALK WITH YOU,
ABOUT YOUR NEEDS, AND HOW THEY CAN HELP.
MORE THAN THAT, YOU SHOULD EXPECT
EXCELLENT PALLIATIVE CARE FROM VA,
TO PROMOTE COMFORT AND COPING.