New Palliative Care Unit Focuses on Patient Comfort at Journey's End
MADISON - When the new Palliative Care Unit (PCU)
opened at UW Hospital and Clinics, there was already a patient waiting for the team's help.
A woman with advanced cancer, who was admitted during the previous night, had decided that her main priority was the quality of her remaining life.
With a plan that focused on her primary goal - managing her symptoms - the patient left the hospital with hospice in place to help her with the rest of her journey.
This initial case set the tone for a unit designed to meet a wide variety of patients and needs. The new PCU builds on the work of the Palliative Care Consult Service, which has been helping patients, families and staff since the late 1990s.
Help With Managing Symptoms, Complex Decisions
While the unit centralizes palliative services at UW Hospital for the first time, the consult service will continue to be an additional resource for patients who are managed by a primary medical team.
"The consult team will continue to provide recommendations for symptom management, assist with complex decision-making, help to define treatment goals and coordinate with hospices," says Kate Ford Roberts, associate clinical nurse specialist in palliative care.
The new, 10-bed unit expands the capacity for palliative services in the hospital. The PCU is staffed by board-certified palliative medicine specialists and nurses with expertise in symptom management.
The variety of services and patients on the unit distinguish palliative care from hospice - a common misunderstanding. While hospice services are available to anyone with a prognosis of six months or less, there is no time limit on the needs of palliative care patients.
"In fact, some patients receiving palliative care do not qualify for hospice services at all, either because they are expected to live longer than six months or because they continue to pursue life-prolonging treatment," says James Cleary, MD
, a UW Health hematologist/oncologist with the UW Carbone Cancer Center.
A Quiet Environment
Although the patient rooms are similar to other general care units, the difference is in the atmosphere of the unit. It offers a quieter environment for patients and families, fewer interruptions for tests and procedures and a lounge and computer room for family members.
"The unit also benefits from a multidisciplinary team made up of physicians, nurses, nursing assistants, a social worker, nurse case manager and chaplain,"says Roberts. "They are all committed to improving symptom management and end-of-life care."
In its short existence, the Palliative Care Unit has served patients with a wide variety of diagnoses and concerns, including:
- Advanced pulmonary disease
- End-stage congestive heart failure
- Traumatic brain injury
Several patients with cancer have chosen to use hospice services while others have opted for more chemotherapy.
"Some patients are able to make their own medical decisions, while others needed family members to express their wishes for them," says Laurie Medenblik, a social worker who works on the unit.
Despite the variety of cases, all the patients had one crucial element in common.
"They recognized that medicine could not cure their conditions and chose to give top priority to their comfort and quality of life," says Campbell. "They engaged in frank discussions about their wishes and goals, and they received emotional and spiritual support."
The Palliative Care Unit offers:
- 10 beds dedicated to patients with acute palliative care needs
- Access to any medical service after a palliative care consult
- Options for patients to be transferred to the PCU or admitted directly
- A multidisciplinary approach to symptom management
- Patient privacy with open visiting hours
- Family support and resources
- A quiet, soothing atmosphere
- Collaborative team philosophy of care
Date Published: 11/29/2007