Special Reports

10 things to know about palliative care in Whatcom County

What is palliative care?

Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illness. It provides patients with relief from the symptoms and stress, with the goal to improve quality of life for both the patient and family.

Palliative care is provided by a specially trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide extra support.

What isn’t palliative care?

Palliative care is not hospice care, which is a specific method of helping people who are terminally ill, likely to die within six months, and not pursuing a cure for their illness.

While hospice uses palliative care techniques for the terminally ill, palliative care is also used for people who are dealing with chronic or acute illnesses, are not terminally ill, or are terminally ill but not near the end of their life.

Palliative care at PeaceHealth St. Joseph Medical Center

Dr. Catherine Bree Johnston was recruited in 2011 to start a palliative care team at St. Joseph hospital. The team began seeing patients that fall, and served nearly 500 hospital patients in 2014 who were dealing with serious illness.

There is also an outpatient palliative care clinic for people with advanced lung cancer. Johnston, while based at St. Joseph Medical Center, is also director of palliative care for the entire PeaceHealth system in Washington, Oregon and Alaska.

Palliative care includes more than just doctors

While palliative care works with patients on their medical care, it also considers the spiritual, emotional and other needs of the patient. The team at St. Joseph Medical Center includes Johnston, who is a medical doctor, as well as a social worker, chaplain, nurse and two other physicians.

Palliative care helps patients who face uncertainty

Palliative care specialists work directly on patient concerns about quality-of-life issues, helping them make decisions in the midst of complex medical treatments with uncertain outcomes.

“We try to help patients determine what is most important to that person and their family,” Johnston says. “When people have a serious illness, it’s not always clear what is the right thing to do.”

Palliative care works with seriously ill patients to look down the road, by helping them find spiritual or emotional support through their faith or a counselor, and by looking at practical and legal concerns if their illness could become debilitating or require full-time nursing care.

You can keep your doctor

Physicians who work on a palliative care team coordinate with a patient’s current doctors to make sure they are in sync, especially if they are treating multiple illnesses.

Or, the palliative care specialists help patients clarify with their doctors if they want more aggressive care, or less, Johnston says.

Palliative care teams have the resource of time

“Most doctors want to do this kind of work,” Johnston says, “but they don’t have enough time to slow down and a take an hour or two with patients.”

Johnston says St. Joseph’s palliative care team can take the time with patients to discuss concerns and the long-term consequences of their illness, including how treatments will effect their quality of life and what choices they have as the disease progresses.

When to ask for palliative care

Johnston says anyone with a serious or life-threatening illness is an appropriate patient for palliative care, including people with cancer, congestive heart disease, or a chronic illness such as amyotrophic lateral sclerosis (Lou Gehrig’s disease), Parkinson’s disease or Alzheimer’s disease.

She also says anyone who is frequently admitted to the hospital, has a symptom or pain that is not well controlled, or has caregivers under high stress should also ask for a consultation with a palliative care specialist.

Insurance often covers palliative care

Most insurance policies cover palliative care as services provided within the hospital. While some insurance companies don’t list the coverage specifically as palliative care, the covered services can be determined on a case-by-case basis.

Palliative care in Whatcom County goes beyond the hospital

Whatcom County is home to the Palliative Care Insttute, a collaboration by Western Washington University, PeaceHealth, Whatcom Alliance for Health Advancement, and others trying to improve the lives of seriously ill people and their caregivers. The institute, through a series of workshops, is working on a “blueprint,” or model, for the county that includes cultural attitudes, local services, advance care planning, and education about treating people with serious and terminal illnesses.