A Life-Changing Program with a Vision for Growth
When a 68-year-old patient arrived for his appointment at St. Jude Medical
Center, he had been in and out of other hospitals over several months,
and was looking for more effective long-term care for his chronic obstructive
pulmonary disease (COPD) and other respiratory ailments.
Approached by a nurse practitioner from St. Jude’s palliative care
team, he and his family were initially concerned: they hoped he would
be able to bounce back and walk without a walker, and he definitely wasn’t
ready for hospice care.
This was a chance to educate this patient and family on what palliative
care can actually do for someone with a serious chronic illness who is
not near the end of life.
“Palliative care focuses on quality of life, whether a patient is
expected to live for years or months,” says Dorothy Lippman Salovesh,
NP, senior palliative care nurse practitioner. “It offers an extra
layer of compassionate support, whether for
symptom or pain relief, navigation of medical information, management of
care at home, or simply emotional comfort.”
The team also helps patients create an advanced directive to document short-
and long-term health care wishes. This ensures family members have a clear
understanding of their responsibility and receive support in decision-making
when the patient no longer can.
The benefits of the highly specialized service are immense. Palliative
care has been shown to help people feel more empowered to cope with their
illnesses, reduce the need for costly procedures and hospitalizations,
and even prolong survival.
Better informed about what palliative care could offer, the 68-year-old
respiratory patient worked with outpatient palliative care nurse practitioner–
Lisa Hanna, DNP, ANP-C, OCN, ACHPN, St. Jude Heritage Medical Group –
and his own physician to create a plan to address his shortness of breath,
mobility issues, difficulty sleeping and other concerns.
The plan included steps to take when symptoms worsened, in hopes of keeping
him at home and out of the hospital—a high priority for this patient
Built on Faith and Foresight
St. Jude Palliative Care Services have been available since 2003, when
Dorothy asked the medical center’s leadership to launch the program
as a nurse consultant service.
“At a time when palliative care services were not common in medical
centers, our leadership had the courage to give it a chance, to see how
it might work at St. Jude,” says Dorothy. “They quickly saw it
was improving patients’ quality of life. It was the right thing to
do and it has made a meaningful difference.”
The program has developed from a single nurse consultant to a team of five
full- and part-time nurse practitioners, two RNs, a social worker, a physician
advisor and hospital chaplains as needed. It is also in the process of
hiring an outpatient medical director and several St. Jude physicians
have become trained in palliative medicine.
Why Expansion is Necessary
The demand for palliative care services is growing. Last year, the inpatient
team served 1,000 patients. Currently, it serves 1,600 patients and that
number is expected to climb.
“With more of our population living with a life-limiting or chronic
illness such as cancer, congestive heart failure, or COPD, it is imperative
to sustain a comprehensive palliative care program that can support the
whole person needs of every patient and family,” says Eugene Kim,
MD, chief medical officer, St. Jude Medical Center.
Expanding outpatient palliative care services is also a priority. Currently,
there is only one outpatient nurse practitioner and one social worker
seeing 900 patients each year, 500 of which were new in 2017.
“By enabling more people to manage their pain and other symptoms
through consultation, physical therapy, nurse visits, IV fluids, music
therapy, or spiritual counseling in the comfort of their own homes, we
help them make the most of the time they have remaining,” says Lisa.
Community Support is Critical
Palliative care is a life-changing service for St. Jude patients. However,
only a limited scope of services is reimbursable by Medicare and Medicaid,
making donor support crucial for expansion and sustainability.
In fact, St. Jude hopes to inspire philanthropic gifts for an endowment
that will ensure the long-term support and security of the palliative
Donor support would allow St. Jude to:
• Provide dedicated, personalized navigation to more patients and families
• Expand the outpatient palliative care program
• Equip more nurses and caregivers with palliative care training and
• Expand community support groups and education on coping with serious illness
“Our team is incredibly caring and enthusiastic. With philanthropic
partners and support from the community, we can build a more robust palliative
care program that can provide supportive care to each and every patient
and family in need of these services,” says Dorothy.
To learn more about how you can help, contact the St. Jude Memorial Foundation
at (714) 992-3033.