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Palliative Care—An Option for Patients in Skilled Facilities

Friday, February, 26, 2010

This month I would like to talk about palliative care in nursing homes. Palliative care can be offered in any setting that you call home but today let's focus on how palliative care can assist in the nursing home setting. If you or a loved one are considering services in a nursing home, then read this information carefully in order to make the best decision regarding your care.

To begin, I'll explain part of my role as a palliative care nurse practitioner.  At times, I may be called into a skilled nursing facility to assist with the symptom management needs of a  particular resident.  At times, I may follow a patient that is transferred to a skilled nursing facility that Ipreviously assisted at home or in the hospital setting. I am there as a second pair of eyes to help maintain and improve the quality of life for the patient. I visit palliative care patients sometimes weekly, bi-weekly, or monthly depending on their specific needs and goals. My role is to assist the medical director, the family, and the patient by seeing the patient as often as needed to manage symptoms and to detect problems early before they escalate into situations that would warrant a hospitalization.

In my role as palliative care nurse practitioner, I will assist with pain management and work with staff members of the nursing facilities as well as the patient's family members to review medication options. When the resident is in need of medication adjustments, I am available to work with their primary physician to make any necessary changes. We are there to assist with pain relief and to provide family education when ever needed. I personally enjoy setting up family meetings which allow all members of the family to express their views and concerns and learn more about their options.

Another reason to ask for a palliative care consultation at a nursing home would be to discuss and complete advanced directives. Part of my role is to explain the differences between the advance directive forms to patients and families. Our palliative care team will also communicate with the staff of the nursing facility as needed in order to ensure the wishes of the patient and family are carried through. Our team will work closely with patients and families to determine their needs and desires so that they can be assured that their wishes are known and will indeed be carried out. This can give you and your loved one peace of mind.

Palliative care staff members are also there to assist with difficult conversations and questions. For example, a family may ask, "Should we place a feeding tube?" "Should we continue dialysis?" "Does Mom/Dad need to be in the hospital?"  We make a point to go over all options in detail and gather information from consulting doctors to make decisions easier. We are always available to talk and discuss these decisions.

Our palliative care team educates patients, families and staff regarding food intake, medication side effects as well as disease processes. We can assist with physical, emotional, financial and spiritual needs as well as discuss transitions to hospice care when appropriate.

Whether you or your loved one has cardiac disease, pain, COPD, Alzheimer's disease or even cancer...ask for a palliative care consultation and let us show you how we can make your life easier by providing comfort, quality of life and ensuring dignity. We would be honored if you would let us take part in the care of your loved ones.

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