Learning to add life to days

by Sharlene Irete

sirete@recordcourier.com

Representatives and caregivers from St. Mary's Hospice and Barton Memorial Hospital Hospice of the Lake/Valley spoke about end of life issues at the Learning to Add Life to Days seminar at Carson Valley United Methodist Church on Thursday.

A group of about 60 people attended the 2009 TRIAD Senior Education Seminar to learn about hospice and palliative care, about how to recognize Alzheimer's disease and how to promote good brain health.

Dr. Kelle Brogan, St. Mary's Hospice medical director, said the aim of palliative medicine is to relieve suffering and improve quality of life.

"Palliative care was created because hospice care just wasn't enough," Brogan said. "We needed to alleviate human suffering, pain - physical and emotional - and help the family cope."

Brogan said palliative care helps the family and patient understand the disease status regarding treatment goals and the hopes for medical care outcome. Palliative care provides management of symptoms and side effects, but also concerns issues relating to wishes of the patient, such as respecting their religious or cultural rituals.

"We have a discussion that relates to the patient. What they know, what they expect and what they want to know," Brogan said. "We communicate options to the patient and help them make choices.

"We do things for comfort. Sometimes they're dying but there's a goal they want to keep, like the birth of a grandchild. I'll do what I can to help them achieve that goal," she said.

"Sometimes it's that the patient has to finish what he started with treatments. To help him get better, we have to control his symptoms.

"We try to focus on all of these aspects. Disruption interferes in healing - not curing - but healing."

What is palliative care?

Also called comfort care, palliative care is a health care program focusing on symptom management of patients with advanced illness. The primary goal of curative care is a cure while the goal of palliative care is relief of suffering.

Goals of palliative care:

Family and patient understanding of disease status and treatment goals.

Symptom and side effect management.

Advance directives, living will, do not resuscitate status.

Preferred religious or cultural rituals.

Key elements of hospice care:

Care versus cure.

Not a place, but a philosophy.

In-home care includes routine, general in-patient, continuous and respite care.

Focus on patient/family's ability to make and act on moral decisions.

A hospice care team includes nurses, doctors, volunteers, spiritual counselors, hospice aides, bereavement counselors, therapists and the patient and family.

Provided services include:

Management of patient's pain and symptoms.

Assistance with patient's emotional, psychological, social and spiritual aspects of dying.

Provision of needed drugs, medical supplies and equipment.

Instruction to family on patient care.

Provides bereavement care and counseling.

What is wanted for terminally ill loved ones:

Honor patient's wishes.

Have choice of services.

Pain control.

Emotional support.

How to receive hospice care?

Hospice receives doctor's orders or the patient or family, friends or health care staff may request an evaluation by a hospice admission nurse.

INFORMATION:

St. Mary's Hospice

(775) 770-3081

(866) 333-8059

Barton Memorial Hospital Hospice of the Lake/Valley

www.bartonhealth.org

(530) 543-5605 for Lake Tahoe

782-1510 for Douglas, Carson, Lyon, Mono and Alpine counties

Carson Valley Medical Center

1107 Highway 395, Gardnerville

783-4815

How to promote brain health:

Mental activity - join social groups, volunteer, read, learn something new, get together with friends, manage stress

Physical activity - exercise, dancing, water aerobics, travel, get enough sleep

Diet - consider Omega-3 fish oils and antioxidants; manage weight, cholesterol, blood pressure; limit caffeine, nicotine and alcohol