In New Orleans, Tuesday, February 13, was Fat Tuesday. In North Texas, it was petite blonde philanthropist Nancy Dedman’s birthday… and not just any birthday. She was making 90 look terrific at the Baylor Health Care System Foundation Board’s quarterly luncheon at the Charles A. Sammons Cancer Center. So, naturally there was cake at the tables that served two purposes — King Cake and Nancy Cake.
Surrounded at a front row table by her buds (Jill Smith, Gloria Martindale, Margo Goodwin, Michal Powell, Tucker Enthoven and Peggy Riggs), Nancy laughed when someone suggested that she was just a kid in 106-year-old Margaret McDermott’s universe.
Other topics making the rounds prior to the program included Baylor Medical Center Foundation Chair Norm Bagwell’s just being back from Dubai. Next on the list is an around-the-world trip in less than 30 days… VNA President/CEO Katherine Krause reported that the Celebrity Chef dinner on Wednesday, February 28, was already sold out, but the lunch still had a scant few places left. The fundraiser benefits VNA’s Meals on Wheels and its Charitable Hospice Care programs… Terry Conner talked about his transition from retirement to working with SVP and Dallas After School… Baylor Scott And White CEO Jim Hinton told Kristi Hoyl, Susan McSherry and Lindalyn Adams about the recent Canine Companions for Independence graduation… Speaking of pooches, Tim Moore reported that the Moore’s family new canine addition was acting like any baby, waking up in the middle of the night for attention…Kristen Hinton was heading back to New Mexico to bring the Hinton kids back to Dallas for the weekend… Others joining the crowd included Dr. Leonard Riggs, Jacqueline Fojtasek, Keenan Delaney, Julie Turner with daughter Amy Turner, Tucker Enthoven, Ken Schnitzer, Scott Luttrell, Jeanne Whitman Bobbitt, Pierce Allman, Alan Engstrom, Sarah Burdi, Alan Friedman and Joanie McNamara.
But once the day’s program got underway, the focus was on how the quality of life for those with a serious disease could be achieved.
Baylor Scott And White Health was the “first health system in the U.S. to implement the Serious Illness Conversation and Care Planning Program, developed by Ariadne Labs, a joint center of Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health.”
Baylor Foundation President Robin Robinson introduced Clinical Director of the Office of Clinical Ethics and Supportive/Palliative Care for Baylor Scott And White Health Dr. Robert “Bob” Fine to discuss the subject of palliative care.
Bob started off by encouraging all to read Atul Gawande’s “Being Mortal.”
He emphasized the difference between palliative services and hospice. Simply put, hospice care is put into place for those with a limited time span. Palliative care is a program to allow a patient with a serious disease, or as in the case of Baylor, having a transplant, to focus on the journey ahead for themselves and their families.
He then explained exactly what palliative care is — it is ideally made up for an interdisciplinary team (physician, NP, chaplain, child life and social worker) with the goal of improving the quality of life for patients and families facing serious illness by relieving four components of suffering, physical, emotional and social and/or spiritual and improving advance care planning and transitional care planning.
Bob described it as a patient who has been diagnosed with terminal cancer should immediately undertake palliative service to not just address their future, but to allow them and their families to work them through the journey ahead.
Robin told of a 94-year-old family friend who had been diagnosed with prostate cancer and was “out of it.” By the time the patient’s kids called Robin, who got Bob involved, it was too late to have a worthwhile discussion.
This subject was obviously not an easy one and not limited to the AARP set.
The point was that palliative care needs to start the moment the diagnosis takes place. In fact, Bob said that primary care physicians should have a conversation with a patient, regardless of their age, on how they want to proceed if such a situation arises. He added that anyone going through a transplant at Baylor meets with the palliative care team to discuss how they want to proceed.
One example was given of a young married man with an autistic child. He was diagnosed with lung cancer and in a lot of pain. While the oncologist treated the patient’s pain, the palliative team treated the family’s needs and well-being.
Bob revealed that it was in 1975 that hospice care came to the U.S. and in 1978 it was provided in Dallas.
But unlike hospice care that deals with the patient’s final days, palliative care addresses the physical and emotional long-term care that could go on for years. However, palliative care is still in the development stages. Bob’s goal is to have:
- primary care physicians add the palliative team to the patient’s program when first diagnosed and
- more palliative experts available to meet the needs of the patients.
In conclusion, Bob listed his “Reaching for the Stars!” goals:
- Fellowship — training the next generation of providers and leaders
- Child Life Services
- Outpatient and Home-based services
- A Palliative Care Unit