Palliative care is often mistaken as synonymous with hospice care, but it is a medical specialty that focuses on improving quality of life and comfort to those with serious, chronic, or end-of-life illnesses.
Palliative and supportive care focus on patient goals of care, advanced care planning, pain, symptom management, and support for patients and caregivers. Palliative and supportive care has never been more important than it is now, during the COVID-19 pandemic.
The dedicated supportive (palliative) care team at the Carole and Ray Neag Comprehensive Cancer Center at UConn Health realized their specialty was a scarce resource during the pandemic, just like PPE, so they jumped in to help.
"We wanted to offer our expertise to staff, patients, and families quickly," says Sarah Loschiavo, APRN/Director of Supportive Care.
They formed the Inpatient Supportive Care Team, which consists of Loschiavo; Nancy Baccaro, Surgical Oncology APRN; Maria Ziello, Oncology Social Worker; Patty Newman, ICU Social Worker; and Katy Wilcox, Hospital Chaplain.
One of the most devastating aspects of COVID-19 is the isolation of patients, with family and authorized health care representatives who may be prohibited from visiting patients in the hospital. As a result, complex conversations to make informed and shared decisions can't be done in person and may even be long-distance.
Supportive Care team members use person-centered care to help patients and families with decisions about quality of life, pain and symptom management, advanced care planning, and other needs.
Family support is critical. The team connects with the family to provide emotional support, clarify questions, bring photos in, coordinate a visit or video care conference using IPads or, in worst-case scenarios, to say their last goodbyes.
While the World Health Organization is reporting the average death rate from COVID-19 is somewhere between two and four percent, the death rate among elderly patients is estimated at 15 to 22 percent. Managing pain and symptoms, ensuring comfort in death, and supporting families and providers is what palliative care does every day.
"Doctors and nurses are dealing with a whole new way of doing medicine that we are not used to, such as being able to read facial expressions or provide a comforting touch to patients," says Loschiavo.
The supportive care team's work isn't limited to patients, though. Nurses, physicians, and hospital staff may be overworked and exhausted during the pandemic. They are experiencing significant stress at work and in their home life. Despite this, they wake up every morning and do it all over again. Moral distress, grief, and frustration can significantly impact health care workers. Spiritual care, team support, and guidance on self-care are specialties of the supportive care team.
The team focuses on being a connection and layer of support for the Inpatient team. On the first day the team began, they held a Hope Huddle with staff as they began their shift to let them know that they are being thought of.
COVID-19 is heartbreaking on so many levels, but the hope is that these patients can recover and move through the process, while the support services team is there to help the patient and family make decisions throughout their illness.
