Lynn Hallarman, MD, Director of Palliative Medicine for Stony Brook University Medical Center, explains what people should know concerning these important services.
What is palliative care?
Palliative care concentrates on reducing the severity of disease symptoms for patients, and helping people plan for and obtain quality of life when facing a life-threatening or life-limiting illness. This can include symptom management—relieving pain, nausea, insomnia, stress, and other debilitating symptoms—as well as counseling and support services that help people move forward in their lives.
Is palliative care the same thing as hospice?
No. Palliative care and hospice are not the same thing. Palliative care can help anyone receiving a life-changing diagnosis such as cancer, catastrophic brain trauma, dementia, emphysema, heart failure, or stroke. In cases such as cancer, the patient may make a full recovery but need palliative care to help get through treatment. In other cases, such as heart failure, the patient will be chronically ill but live a long time. Hospice care, on the other hand, focuses specifically on relieving suffering during the last months of life. It is one of many aspects of palliative care.
What is unique about Stony Brook’s approach?
Our program, called Survivorship and Supportive Care, focuses on a “whole person” approach, providing compassionate care and guidance. We offer our services directly to patients and families, and also seek to make changes in the way palliative care is viewed and accessed. Good palliative care starts at the time someone is diagnosed, so that problems can be averted or reduced through anticipatory planning. Our nurse practitioners reach out to physicians, nursing staff, students, and the community through a variety of programs. Our program received national recognition—the 2009 Quality in Palliative Care Leadership Award from the National Consensus Project for Quality Palliative Care.
How can patients who need palliative care be helped?
As people get sicker, or go through difficult treatments, their lives can become chaotic with all kinds of problems, distractions, pain, misery, confusion, and anxiety. We have the tools and techniques to sort through the issues. Our program offers help to effect calm, allowing patients to regain control of the things important to them. We call this process “decreasing the noise.” And when you help people to do that, you can see them become themselves again. For example, we recently worked with a patient receiving chemotherapy and radiation treatment for head and neck cancer, which is often associated with a high symptom burden. This young man was very anxious about his treatment and we saw him daily. We aggressively managed his pain and other symptoms and made it possible for him to finish his treatment. His oncologist recently told me this patient was back to work and his normal activities. We see such outcomes frequently, and it is deeply satisfying.
How does palliative care apply to patients with advanced dementia?
Families of patients with advanced dementia often need help understanding the nature of the disease so they can make informed choices about their loved one’s care. Many of these patients are in and out of the hospital repeatedly, cannot participate in their treatment plan, and are vulnerable to the complications of frailty. Families face many difficult decisions and often feel very alone. We help them anticipate problems and find solutions.
What’s ahead for palliative care at Stony Brook?
We plan to further broaden our reach by developing a specialized palliative care inpatient unit. Fund-raising for this important initiative is ongoing, and we ask for your support. To learn more about how to make a gift, please contact the Medical Center Advancement Office at (631) 444-2899.
For more information about our Survivorship and Supportive Care Program,
call (631) 444-2052 or 638-2801.
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