Everybody Hurts: Caring for California
27-Sep-2018 1:05 PM EDT
At some point, most Californians will need palliative care, a specialized kind of care that provides relief from the symptoms, pain and stress that come with almost any kind of serious illness. Right now, though, there simply aren't enough people trained in the field. The CSU Institute for Palliative Care is working to change that.
If so many Californians will experience a serious illness at some point in their lives, where will the nurses, social workers and other health care professionals who understand how to provide this kind of compassionate care come from? Put another way: Who will take care of us? Many in the state are likely to be trained by the CSU Institute for Palliative Care, a center nearly unique in the country in its mission.
WHAT IS PALLIATIVE CARE?
This approach focuses on the patient, not the disease. It brings together nurses, doctors, psychologists, social workers and spiritual counselors, all collaborating to support a patient and his or her family during a serious illness. It's a treatment philosophy with the goal of easing pain and suffering while maintaining or stabilizing a patient's quality of life. Palliative care has become the gold standard of care for seriously ill patients.
PALLIATIVE CARE VS. HOSPICE CARE: WHAT'S THE DIFFERENCE?
Anticipates, prevents and manages suffering
Any stage of life
End of life
Begins at time of diagnosis
Begins with life expectancy of less than six months
May parallel curative treatments
No curative treatments; comfort care only
“Palliative care is anticipating and addressing suffering from any serious illness. It can be used at any age and at any stage of a serious illness.
It's not just care you get when you're on the brink of death.
It's not just offered when you're terminal, or even within the last one or two years of life.
Palliative care should begin with the diagnosis of a serious illness and follow the patient all the way through.”
— Jennifer Moore Ballentine, executive director, CSU Institute for Palliative Care
A PATIENT-CENTERED APPROACH
Psychological Support: Social workers and psychologists meet with patients before a treatment plan starts and whenever the plan changes to help them cope with stress, anxiety and fears they may have about their treatment or prognosis.
Spiritual Support: A palliative care team often includes a chaplain to identify a patient’s spiritual needs during truly difficult periods, including end-of-life.
Family Support: Palliative care team members often support a patient’s family as well. This can include small acts of kindness such as having a “comfort cart” with beverages and snacks brought into the room so family members can stay with the patient, or more substantial help such as organizing resources for help at home or for financial assistance.
Physical Support: The patient’s medical team collaborates with the patient and his or her palliative care experts to determine the best way to reduce pain and increase comfort and tailor treatment to meet the patient’s goals.
RISING TO MEET THE NEED
"The need for palliative care is exponentially growing as the population ages, as more people are suffering from more than one chronic condition at a time," says Jennifer Moore Ballentine, executive director of the CSU Institute for Palliative Care, which is based on the CSU San Marcos campus.
- A 2017 California Health Care Foundation (CHCF) study showed that while access to palliative care services in California increased between 2014 and 2017, there's still a gap across the state's 58 counties. The institute aims to serve that need by offering accessible, affordable online education for professionals in the field and students in training.
- Since its founding in 2012, the institute has trained 9,366 current professionals (physicians, nurses, social workers, chaplains, care managers), and more than 17,000 pre-professionals (such as CSU nursing students and students in other allied disciplines) have had some palliative care content as part of their education.
- Health care professionals from all 50 states and 27 countries have taken online courses through the institute.
NURSING EDUCATION: A FOUNDATION OF PALLIATIVE CARE KNOWLEDGE
Veronica Morales is a nursing student at CSU San Marcos studying palliative and hospice care. At CSUSM, nursing students in their senior year choose a specialty they'll focus on during their externship. Meet Veronica and learn about her experience studying palliative care.
“Palliative care is a hot field in nursing because so many programs are being developed, hospices are growing, inpatient services are growing, community-based services are growing. With preparation, someone could step right into a challenging and well-paid job.”— Jennifer Moore Ballentine
CSU INSTITUTE FOR PALLIATIVE CARE: A LEADER IN TRAINING
FOR PROFESSIONALS: The Institute offers online and in-person palliative care courses to health care professionals and convenes the National Symposium for Academic Palliative Care Education and Research (this year, on October 11 & 12, in San Diego) with the goal of advancing education and research for this discipline nationwide. LEARN MORE
FOR STUDENTS: The Institute partners with CSU campuses to incorporate elements of palliative care training and awareness into the coursework for nursing and other related fields, including psychology, sociology, kinesiology, biology, human development, social work, public health and more. LEARN MORE
FOR THE COMMUNITY: The Institute advocates for palliative care and related topics throughout the community. For instance, Sharon Hamill, Ph.D., faculty director for the Institute at CSUSM, established the "What Gives Your Life Meaning?" campaign to raise awareness about advance directives. LEARN MORE
MORE SUPPORT FOR PALLIATIVE CARE
FOR STUDENTS: If the Palliative Care and Hospice Education and Training Act (PCHETA) is passed by the U.S. Senate, the four-year program would make available about $20 million a year in grants and contracts to support palliative care and hospice education in pre-professional schools, residencies and fellowships, and continuing education settings across the U.S., as well as creating a national public awareness campaign and directing additional NIH funds toward palliative care research. "This could be a game-changer for palliative care education," says Jennifer Moore Ballentine.
FOR PATIENTS: With the passage of Senate Bill (SB) 1004, California became the first U.S. state to make palliative care part of services provided under Medicaid/Medi-Cal managed care plans, effective January 2018.
The CSU Institute for Palliative Care has contracted with the California Department of Health Care Services to provide palliative care training for qualified Medi-Cal providers and their clinician staff. Also in January, SB 294 went into effect; it allows hospices to offer palliative care to patients who are still seeking curative treatment.