| Study Finds Early Palliative Care Extends Life and Improves Quality of Life for Cancer Patients
A landmark study by researchers at Massachusetts General Hospital and reported in the New England Journal of Medicine found that receiving palliative care early in treatment not only improved quality of life but also survival in patients with newly diagnosed metastatic non small-cell lung cancer. Patients receiving palliative care intervention experienced less depression and survived approximately 2.7 months longer.
Palliative care is provided by a team consisting of doctors, nurses, nutritionists, social workers, chaplains, pharmacists and others, who focus on the whole person to provide comfort, ease pain and help the patient, family and caregivers make important decisions.
Commenting on the study, Diane Meier, MD, director of the Center to Advance Palliative Care wrote: “The results of the study show that palliative care is appropriate and potentially beneficial when it is introduced at the time of diagnosis of a serious or life-limiting illness – at the same time as all other appropriate and beneficial medical therapies are initiated.”
Dr. Meier said in The New York Times: “It shows that palliative care is the opposite of all that rhetoric about ‘death panels.’ It’s not about killing Granny; it’s about keeping Granny alive as long as possible — with the best quality of life.”
Doctors and patients “traditionally see palliative care as something extended to a hospitalized patient in the last week of life,” said Dr. Jennifer S. Temel, an oncologist and co-author of the paper. “We thought it made sense to start them at the time of diagnosis. And we were thrilled to see such a huge impact.”
The Rev. George Handzo of HealthCare Chaplaincy notes, “While the results are impressive and worthy of great note, we should be aware that there is no report of psychosocial-spiritual care in either study condition. We would assume that chaplaincy care would have improved quality of life for those in the study who received palliative care and those who did not.”
Chaplain Holly Gaudette of HealthCare Chaplaincy has had considerable palliative care clinical experience. “Palliative care at its best,” she says, “involves intensive communication between medical teams, patients, and families. It involves long conversations, emotional investment, and real relationship-building, in ways that other medical specialties may not. We know that patients receiving adequate pain management, spiritual and emotional support, and good symptom control have better quality of life. What is crucial in this study is the benefit of early palliative care.”
She adds, “Finally, we would do well to remember that, as chaplains, we offer spiritual and emotional support not only to patients and their families, but also to staff.
NBC Nightly News with Brian Williams on September 10th featured a segment on the research reported in the New England Journal of Medicine which you can find here: http://bit.ly/93tR1Z plus interviews with a palliative care physician and a patient. For even more information, please click on the following: http://bit.ly/c2bVwH, http://nyti.ms/cVSeTY, http://bit.ly/cE4PPL and http://bit.ly/b1z9yM
New York State Law Now Mandates Palliative Care Information for Terminally Ill Patients
Patients’ rights in New York State gained a large boost last month with the passage of the Palliative Care Information Act.
The law requires New York doctors and nurse practitioners to offer terminally ill patients information and counseling that includes a full range of information about end of life care options, including hospice care, aggressive pain management, and palliative sedation. The patient is then empowered to control his or her own medical care decisions.
Where the patient lacks the capacity to reasonably understand and make informed choices related to palliative care, “the attending health care practitioner shall provide information and counseling under this section to a person with authority to make health care decisions for the patient.”
The law reflects the growing realization of the value of palliative and end-of-life care, and that patients and their families often do not know what options for palliative care and pain management are clinically and legally available to them at the end of life. Further, patients and families may be reluctant to initiate conversations with physicians and nurses on this topic.
Claire Haaga Altman, HealthCare Chaplaincy COO, says, “HealthCare Chaplaincy has consistently supported this type of legislation within New York State and at the national level. We and many other organizations take exception to the malicious ‘death panel’ charges, and support the new bill introduced by Congressman Earl Blumenauer (D-OR) – ‘Personalize Your Care Act of 2010.’ Also, we disagree with the Medical Society of the State of New York which objects to the new bill saying it would intrude ‘unnecessarily upon the physician-patient relationship’ and mandate ‘a legislatively designed standard of care.’”
HealthCare Chaplaincy staff chaplain Holly Gaudette, adds, “Ideally, this law will help to stimulate conversations in which patients receive accurate information about treatment options for palliative and end of life care. These are not simple conversations, however, and many physicians hesitate to broach the subject. Yet with the interdisciplinary team model serving the patient, no physician need feel that he or she is operating alone.”
Palliative Care: “To Relieve Suffering While Maximizing Life”
This letter to the editor of the Journal of Palliative Medicine from two leading palliative care physicians explains well the benefits of palliative care and addresses directly the misconception that palliative care is solely end-of-life care:
From Journal of Palliative Medicine
“Branding Our Field”
Volume: 13 Issue 9: September 13, 2010
http://bit.ly/dkAE7m
Dear Editor:
Our white doctor’s coat says Palliative Care. As patients read the name and title, we are often asked to define palliative care and to distinguish it from hospice care. Our elderly parents still do not understand what we do. The cover of the April issue of Journal of Palliative Medicine has two of the six feature articles with “end-of-life care” in their title while the current issue of Journal of Pain and Symptom Management has three cover articles about “end-of-life care” or “death.” If our goal is to maximize the benefit to all patients in need of palliative care, we do them a dreadful disservice through our choice of words. To facilitate the inclusion of palliative care in the care of patients with advanced illness, no matter how long they may have to live, we cannot have the door jammed by misconceptions of what we offer that result from the very words we ourselves use to talk about what we do. We are more than end of life physicians.
One of us was recently asked to rename our Palliative Care Unit to something without the word palliative because people think it is a hospice unit or limited to those who are clearly dying. Our field should strive to align treatments with patient preferences, early in the disease trajectory. Our mission is to relieve suffering while maximizing life. If we continue to tattoo ourselves as end of life doctors, we limit our ability to help patients in need, earlier in their disease. As a member of a local Heart Failure Task Force, or when we are speaking to professional audiences, we must constantly educate colleagues that palliative care is perfectly appropriate for those patients with New York Heart Association Class IV symptoms, or persons with Alzheimer’s disease, or chronic lung disease, or frailty; even though they are not actively dying. Patients with advanced illness benefit from palliative care well before their terminal hospital admission; when we generally are called to see them in consultation two days before death.
Dana Lustbader, M.D. — Hofstra Medical School, North Shore LIJ Health System, Manhasset, New York.
Diane E. Meier, M.D. — Lilian and Benjamin Hertzberg Palliative Care Institute, Department of Geriatrics and Adult Development, Department of Medicine, Center to Advance Palliative Care, Mount Sinai Medical School, New York, New York.
Check Out The Latest Beacon
Check out the latest news of HealthCare Chaplaincy in our bulletin The Beacon, which you can find online here. Among the stories you’ll discover:
- The New Palliative Care Campus — A Dream Begins to Take Shape
- Bev’s & Joe’s Palliative Care Story
- HealthCare Chaplaincy in Keynote Address at George Washington University
- Summer Students Give HealthCare Chaplaincy High Marks
Follow us on for the latest news about HealthCare Chaplaincy and the growing fields of palliative care and professional multifaith chaplaincy care. |