Palliative services: A supportive care umbrella | Coming of Age…Again

By Don Desonier

Dementia caregiver coach and family mediator

When Pam was diagnosed with ovarian cancer, she, her husband Eric and their two adult daughters, were in shock. Pam had been, as Eric liked to say, “in fine fettle” — happy, full of life and the picture of good health. No one expected this. Fear, anxiety and dread descended on the entire family as they faced the grave uncertainty of this diagnosis.

Following a referral from their primary care physician, Pam and Eric had their initial appointment with their oncologist. When they shared with her the relentless stress they were experiencing, the oncologist strongly suggested they explore palliative services. She explained that palliative care would address their worries and concerns and a whole lot more.

Eric and Pam had heard of palliative care, but assumed that meant hospice care if Pam was diagnosed with six or less months to live. They certainly weren’t ready for that. Their oncologist told them this was a common misconception and set up a referral consult for them with a palliative care specialist at a nearby health center.

Eric and Pam were quickly assured by the specialist that palliative care services were available to the entire family at the time of diagnosis of a serious illness. Pam’s cancer diagnosis certainly fit that criteria and this was regardless of the trajectory of her illness. The specialist explained that a palliative care team of professionals would help them clarify their care goals, to ensure all medical care and treatment intervention options they chose throughout Pam’s illness would honor those goals. This was especially important to Pam and Eric as they were concerned about the impact on Pam of potentially needless and ineffective — and costly — treatment interventions. They were also told that pain control, physical comfort, access to outside community resources and ensuring coordination among Pam’s various care providers were also part of the palliative care support available to them.

To their immense relief, Pam and Eric soon found themselves surrounded by a palliative care team that included a hospice medical director, nurse, social worker, pharmacist, certified nurse assistant and hospice and palliative care volunteer. They also knew that spiritual care was available if desired, along with bereavement services. Finally, they were told that if Pam was ever diagnosed with six months or less to live, hospice could be engaged, with the proviso that curative treatment could no longer be provided.

Here are a few excellent and invaluable informational resources in Washington state for palliative and hospice care services, and at Medicare.gov for Medicare coverage:

End of Life Washington: endoflifewa.org/end-life-options-2

Washington State Hospice & Palliative Care Organization: wshpco.org

EvergreenHealth: www.evergreenhealth.com/palliative-care

Medicare.gov: www.medicare.gov/coverage/hospice-and-respite-care.html

“Coming of Age… Again” is edited by the Kirkland Senior Council, a group the City of Kirkland created in 2001 to advocate for older adults in our community. The council is made up of people living or working in Kirkland who want to help improve and maintain the quality of life for people in Kirkland as they grow older. Membership is open throughout the year.