Straight TalkA weekly update from management on the issues that matter most. Mar 1, 2018 Palliative care is an extremely valuable but underappreciated and underutilized resource for patients and families facing serious illness. Although we live in a culture that avoids thinking about and addressing end-of-life care, everyone should be aware help is readily available when needed. Unfortunately, we will all need help someday. Two true patient vignettes shared recently by NCH Director of Palliative Care Dr. Shirley Codada with Editor-In-Chief of Gulfshore Life, David Sendler, make the point that patients’ comfort and wishes come first: A man came in with a neurodegenerative disorder. Though he was on life support for breathing, he believed he would survive. He really wasn't going to get better, and we worked to help him accept that. He didn't have much family in the area. He couldn't talk, but we got him to where he was smiling a lot and brought in a chaplain who helped him accept his situation. In the end, he wanted no more machines to keep him going. His one wish was to see the Super Bowl on a big screen, and we managed that for him. He died a week later. Another patient had suffered a stroke. He couldn't move or talk, but understood everything. We talked to his family about what he would want. But along the way, we used an eye-blinking system with him—he'd blink his answers to our questions. Using this system, we learned that—contrary to what his family thought he wanted—he was willing to live like this and be with his family. He agreed to let our support system work for him. He actually started moving a little, and we ended up discharging him to a place for rehab. Collaborating closely with our Palliative Care Team that includes four nurse practitioners—Amanda Brink, Karleen Hanna, Omar Villarreal, Martina Williams, as well as Chaplain Jennifer Dant and Social Workers Nancy Dominguez and Sylvia Currie—are our Geriatric Team led by Dr. Joseph Bandeira and our out-patient behavioral health specialist Esther Mugomba-Bird. The synergy of Palliative Care, Geriatrics, and Behavioral Health were summed up in a conversation with Palliative Care RN Renee Hardy. She shared her thirty-six years of experience—bedside, ICU, nursing home, occupational health, and school nursing—“put all together” so she could connect at a most stressful time for patients and families. Chronic end-stage illnesses require a multitude of nursing skills—emotional support, comprehensive understanding, social connectivity, medical knowledge, and expert skill. At the NCH Medical Plaza on the Baker Campus, we have the new, beautiful, and functional Patty Baker Outpatient Palliative Care Center and Brookdale Geriatric Center co-located offices, facilitating a “one stop shop” for patients with overlapping needs. In the same building at 311 9th Street North, we have NCH Imagining Services and out-patient lab drawing capability. Convenience matters for frail, elderly, stressed folks who desire and need coordinated care. Palliative care, geriatrics, and behavioral health help everyone live a longer, happier, and healthier life, particularly those most challenged with chronic or end-stage illnesses. P.S. DO YOU HAVE A COLLEAGUE OR FRIEND WHO WOULD BE INTERESTED IN UPDATES? Please enter their email address at nchmd.org/straighttalk, and we will add them to our complimentary mailing list.