The Palliative Care Program at University of Iowa Hospitals and Clinics helps patients dealing with a terminal medical condition and their loved ones to cope with all the issues that arise during the end-of-life process.
Rick Dobyns, MD, MSPH, a family medicine specialist and director of the Palliative Care Program at UI Hospitals and Clinics , has these comments:
Why is it important for UI Hospitals and Clinics to offer palliative care?
It's important for all hospitals to offer palliative care. The UI Hospitals and Clinics, in particular, because we are a comprehensive hospital that offers the complete range of medical care. When I introduce myself to patients and their families needing this specialized health care, I introduce myself as a hospice doctor since most Americans understand the unique services offered by hospices. Essentially, palliative medicine is the same as hospice medicine, it's just called that when it's done in the hospital setting.
What do you consider the most important features of palliative care?
When we break it down, we focus on the aggressive management of symptoms and suffering , rather than focusing on cure. You would think that modern medicine could do it all, which is aggressively pursuing care while aggressively minimizing symptoms. However, many times the intensity of medical services necessary to optimize a cure is very uncomfortable.
For instance, think about all the wires going into the body, everything going on in the intensive care unit. If you want to maximize your chances of surviving, that's what put yourself through but it is uncomfortable. However, if you want to reduce suffering, if that is what's important - and there are many types of illnesses, especially here at a tertiary health care center, that the chance of a person surviving it are quite minimal.
Which patients and families benefit from palliative care services?
Most people used to think of cancer because that's a fairly predictable illness that causes death. Hospice and palliative medicine has broadened beyond just cancer now and includes all types of illnesses that lead to death. Even dementia is something that we work with.
We don't focus on just symptoms and suffering, we also are called to have those very difficult conversations that need to occur to change the care plan. People don't come to University of Iowa Hospitals and Clinics because they think we're going to give up. Unfortunately, that's what people think when they have a life-limiting illness. And you can understand that it takes some very deft language to be able to talk with patients and their families about these sorts of things. We're often called in to have those conversations.
What are some of the common misconceptions about palliative care?
Sometimes people think we can only be useful when death is inevitable and coming soon. We can offer a lot of advice on how to combine the aggressive approaches afforded by high technology medicine and palliative medicine. You know it isn't just one or the other, most of the time it's a little bit of both. As people get old or they become more frail, they like to combine the very high-technology aggressive care that we do so well here with the softer, less technologic approach afforded by palliative care. And some people think they have to say either yes or no, and it's just not true.
It sounds like there are multiple choices or multiple options, depending on what best suits a patient and/or their family?
Absolutely, and these are conversations that patients and their families are desperate to have, and we're the people who will have those conversations. Many times I'm called by my colleagues to come in and do just that.
How can people learn about the Palliative Care Program?
Interested people can call our Palliative Care Program at University of Iowa Hospitals and Clinics at 319-384-8690 to request more information from our staff. |
