By Vanessa Orr
While bedside healthcare is geared toward helping patients, palliative and hospice professionals who care for people with life-limiting illness have a different focus than traditional providers. Their goal is no longer to heal or cure the patient, but to make the person’s remaining days as comfortable and pain-free as possible and to ease the transition to come.
“Generally speaking, one of the things that sets us apart is being comfortable with what most people find uncomfortable, including suffering and pain,” said VITAS Healthcare Associate Medical Director Angelica Torres Morales, MD, FACP, HMDC. “Most clinicians are trained to try to cure patients and are rarely comfortable with the natural process of death. While everyone goes into healthcare wanting to help people, hospice and palliative medical professionals try to help in a different, more comprehensive and compassionate way.”
Dr. Torres Morales, who first trained in internal medicine, was drawn to helping patients and families during one of the most difficult times in their lives. “I originally planned on a career in genetic research and didn’t expect to have contact with patients at all until I realized that what I enjoyed most was being at bedside, hearing their stories and doing my best to help them,” she said.
“In my second year of residency, I treated a patient who had spent a prolonged time in the hospital,” she added. “She told me, ‘Whatever you do in the future, do it so that your patients don’t suffer as much as I suffered.’ That helped fuel me to become a patient advocate.”
Palliative care is focused on relieving symptoms, pain and stress for people living with serious illnesses, such as cancer, heart disease or dementia. It can be provided alongside curative or disease-modifying treatment, such as chemotherapy, to help with symptom management and treatment side effects. Palliative care professionals also assist families in navigating complex medical decisions.
“Families are a big part of our plan,” said Dr. Torres Morales. “Not only are they very supportive of the patient, but many times we depend on them to execute the plan of care.
“Oftentimes, patients may not be very conscious of their circumstances, but families are there 24/7,” she added. “We want to try to ameliorate their struggle in the best possible way with our team of social workers, traveling nurses, physicians and more. It takes a village to take care of these patients.”
According to Dr. Torres Morales, there are many misconceptions about palliative and hospice care, including the fallacy that this care is provided with the intention to expedite death. There is also a lot of confusion around morphine and other medications, and end-of-life nutrition.
“These medications are potent and effective to treat symptoms, but we get a lot of resistance from patients’ families about using them,” said Dr. Torres Morales. “People also misunderstand that at the end of life, people lose their appetite and ability to eat, but that does not imply suffering. Feeding them can actually cause discomfort.”
While helping people through the end-of-life journey can be heart-wrenching, Dr. Torres Morales said that she wakes up every day being grateful that she can help patients and their families. “I’m honored to be able to hold their hands through at least part of the journey, not only by taking care of symptoms but by providing psychosocial support,” she said.
She added that she wished that families who have had positive experiences with hospice and palliative care would share their stories with the world as a way to encourage other people who would benefit from this type of care.
“People are scared or have misconceptions or false narratives around end-of-life care, so who better to be our PR than someone who went through the experience,” she said.
She also wishes that more clinicians would be open to referring patients to hospice and palliative care earlier, so that these patients could experience less suffering and fewer symptoms as they transition to end-of-life.
“Referring patients to us is not a synonym of giving up or failure,” she said. “Everyone unfortunately, will have to go through end-of-life, and palliative care is much needed in this world.”
Learn more about hospice eligibility and refer patients at VITAS.com/Refer or call 800-93-VITAS, available 24/7/365.
