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Palliative Care Unit

Palliative Care UnitMADISON - The new palliative care unit at UW Hospital and Clinics, it will mean much more than adding 10 new beds. It will help break down barriers in health care and become a transition point in patient care, according to James Cleary, MD, a UW Paul P. Carbone Comprehensive Cancer Center specialist in palliative care.
“The new unit will help integrate the passage from treatment through other stages of care,” says Cleary. “It will prevent and relieve suffering, and improve the quality of life for patients with serious illnesses.”
Palliative care staff typically work along side the primary care team to help patients develop a comprehensive plan for care as a disease advances, assisting with decision making for treatment options, managing symptoms and providing emotional support. The unit will be available to patients from all areas of the hospital, including the Emergency Room. Whether coming from oncology, general medicine, ICU, or other units, Dr. Cleary and his staff will care for any patient with a life-limiting illness.
“A great example would be stroke patients,” says Cleary, “if there is no surgical or other intervention available, we’ll be able to keep them comfortable in the palliative care unit.”
Cleary is one member of an interdisciplinary team that administers palliative care at UW Hospital and Clinics. Along with nurses, social workers, chaplains and other professionals, he works with any patient seeking comfort, although most are usually approaching death.
“I once had a patient who was in pain because of a spiritual crisis,” explains Cleary. “He had committed some misdeeds earlier in life, and he was scared he was not going to heaven.”
Although morphine and other pain medications were available, Cleary chose to help the patient in a different manner.
“I couldn’t tell him he was going to heaven, but I could certainly lessen his pain by helping him cope with his anxiety,” says Cleary. “Spirituality does not just have to be about a single religious view, I can talk about life with patients, too.”
“The overall focus of the program is to help patients maintain the best quality of life possible,” says Kate Ford Roberts, associate clinical nurse specialist in palliative care.
She stresses that palliative care seeks to be consistent with a patient’s goals and choices for care. Often, as patients approach death, their priorities shift from therapy and prolonging life to comfort and quality of life.
“As people become less active, and when cure-oriented treatment comes to an end, palliative care becomes a much more attractive option,” she explains.
However, palliative care patients can receive treatment regardless of life expectancy, which distinguishes the program from hospice care. The unit will also be family-centered, featuring a family room and small kitchen. Visiting hours will not be enforced.
“We want to make it as home-like as possible in a hospital,” says Roberts. “Palliative care does not just treat patients; it works with their family and friends as well.”
Members of the palliative care team offer care and support specifically to family members, and help them with advance care planning. They also follow up with the family after the death of their loved one.
When the unit opens, it will bring to reality a 14-year vision for Cleary. It also reflects the changing culture of health care in the United States.
“It is a model of care that is supported by the World Health Organization,” says Cleary.
Cleary and Roberts agree that both hospital patients and those who are homeward bound will be the ultimate beneficiaries of the new unit.
“For those who go home, as well as those who never go home, it’s the quality of the days and weeks that are left that concerns the palliative care team,” said Roberts. “Our focus is to make each day as good, meaningful and symptom free as possible.”

Date Published: 12/28/2007

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