LINCOLN (SNR) - As part of its mission to "…nurture the healing ministry of the Church" with an emphasis on human dignity and health, Saint Elizabeth Regional Medical Center in Lincoln provides both palliative care and Hospice care to patients with serious illnesses.
Hospice is the more commonly known of the two. It’s a form of comprehensive comfort care that improves the quality of a patient’s final days. Patients who receive Hospice care are no longer seeking treatment to end their illnesses or extend their lives.
Palliative is a broader form of comfort care, focusing on the relief of pain, fatigue, loss of appetite, shortness of breath and other issues that can be part of a serious illness, while the patient continues to receive treatment.
Dr. Richard Morin, Saint Elizabeth’s palliative care and hospice medical director, explained his three major objectives for palliative care.
"First is to provide comfort and reduce suffering," he said. "Second is to maintain their dignity. Third is to honor them as a person, and that also means listening to them and making sure whatever we’re doing is congruent with their desires."
Board certified in internal medicine, infectious diseases and palliative care, Dr. Morin found his calling to palliative care while caring for patients dying of AIDS at a time when there wasn’t any form of treatment.
"I had to learn what I could do to decrease their suffering," he recalled.
While the discipline is still fairly new in the United States — only recognized in the last 25 years or so — palliative care has been practiced regularly for some time in Europe. But Dr. Morin said the concept is far older than most people realize.
"As far as health care, it’s had a major role since the Greeks," he said. "Now that we can control more things [with advanced medical treatment], suffering is put on the back burner, and we don’t do palliative care as well as we used to."
Hospice care has been provided through Saint Elizabeth’s since 1968, while palliative care has only been offered in the last five years or so, according to Dr. Morin. The resurgence of interest in palliative care helps protect the dignity of those afflicted with serious illnesses.
The Saint Elizabeth’s palliative care team is generally brought in by primary care physicians when a patient is suffering a critical illness such as cancer, cardiac disease, respiratory disease, kidney or liver failure, AIDS, dementia, ALS (Lou Gehrig’s Disease), multiple sclerosis, etc.
With his team of two nurse practitioners and two nurse coordinators, Dr. Morin works closely with patients, their families and their primary care physicians to determine the best course of action in each individual case.
While the patient is admitted to the hospital, the team also includes the social services department, chaplains and others who can help provide the right kind of care.
Generally, it’s a matter of looking at the patient’s discomfort and devising a system of medication, diet, and so on to treat his or her symptoms.
"A lot of it is psychological support, family dynamics — it varies considerably from person to person," Dr. Morin said. "We have to be rather creative at times in how can we get this particular problem for this particular patient under control."
Dr. Morin also helps educate patients as they navigate their treatment options, which can be tricky if there is a moral question involved.
He assured that everything the Saint Elizabeth palliative care team provides adheres exactly to the directives issued by the United States Council of Catholic Bishops.
"We really do follow it right down the line," he said. "We’re able to meet the directives and still provide the care and comfort that people need. If we have a concern, we’ll ask our ethics committee to consult with us."
With the palliative care team working to improve the patient’s ability to cope with their ongoing medical treatments, he or she can carry on with daily life with less stress and discomfort.
At times, Dr. Morin finds that a patient has hidden misgivings about the primary treatment he or she receiving for the illness, but he or she is afraid of disappointing family members if they speak up. Oftentimes, he said, the spouse and children feel the same way, but nobody wants to be the first to say so.
"Sometimes I’m the guy who has to facilitate the conversation," Dr. Morin said. "Part of my job is to help families and patients in particular express their wishes."
He said he finds his work in palliative care to be both challenging and rewarding.
"Although I don’t cure anybody, if I can reduce suffering, that’s my satisfaction," he said.
Anyone who is battling a critical illness — or who has a loved one who is suffering — can consult with their primary care physician to see if palliative care would be helpful in improving well being and managing the stress of ongoing medical treatments. For additional information, visit the Saint Elizabeth Regional Medical Center website at saintelizabethonline.com and search for "palliative."