Palliative Care Definitions and Opportunities

Chaplain Ted TaylorFellow in Hospice & Palliative Care

What is Palliative Care? VIDEO: “You are a Bridge”

https://youtu.be/lDHhg76tMHc

Improves Quality of Life Treats people suffering from serious and

chronic illnesses Focuses on symptoms such as

Physical pain Shortness of breath Fatigue Constipation / Nausea / Loss of appetite Difficulty sleeping Depression and other psychological distress Emotional pain Spiritual pain

Improves Quality of Life Helps people gain the strength to

carry on with daily life Improves the ability to tolerate

medical treatments Helps people have more control over

their care by improving their understanding of treatment choices by considering the goals of care

A Partnership of Care An interdisciplinary team approach

Physician Nurse Social Worker Chaplain Pharmacist Dietitian Other practitioners / therapists

A Whole Person Approach

The Case for Palliative Care 90 million people in the US are living with

serious / life-threatening illness This number will double in the next 25

years Most people living with serious illness

experience Inadequately treated symptoms Fragmented care Poor communication with practitioners Enormous strains on family caregivers

Growth & Barriers In 2001 almost no hospital-based

palliative care programs By 2011 63% of hospitals with 50+

beds have a palliative care team Barriers to continued expansion

WORKFORCE RESEARCH REIMBURSEMENT / INVESTMENT

Workforce Barriers Lack of trained physicians nationwide:

1:1,200 palliative care doctors 1:71 cardiologists 1:141 oncologists

A new specialty (formally recognized in 2007)

No Medicare funding for training due to cap on GME expansion

Increasing demand for nurses, other clinicians certified in palliative care

Research Funding (NIH, Institute of Medicine) for

palliative care research not keeping pace with the growth of the discipline

Need to strengthen the knowledge base supporting clinical practice

Access & Quality Business model based on cost

avoidance, not revenue generation Accreditation standards only just

beginning to require palliative care

Our Unique Opportunity Dartmouth Atlas Study

NJ has the most aggressive & costly care at the end of life than any other state

Studies show higher utilization correlate with Lower patient satisfaction Poorer clinical outcomes

60 Minutes report: “The Cost of Dying: End of Life Care” (August 2010)

EOL Planning Advance Directives (“5 Wishes”)

Healthcare Proxy Living Will

POLST