Date: 07/08/2009

Introduction to Palliative Care


Votes: View--> Action Taken:

11:01 AM

The committee took a brief recess.

11:10 AM -- Introduction to Palliative Care

The committee reconvened. Dr. Dave Nowels introduced himself and provided a handout to the committee (Attachment C). He stated that he works at the Life Quality Institute, Department of Family Medicine, University of Colorado at Denver and Health Sciences Center and is Program Director for the Colorado Palliative Medical Fellowship. Dr. Nowels provided the World Health Organization's definition of palliative care which is a interdisciplinary health care service that specializes in the relief of suffering and the achievement of the best quality of life for patients with advanced illness. He went on to further explain that palliative care focuses on relief of pain, stress, and other debilitating symptoms of serious illness. He also provided statistics regarding how individuals die in the United States. He stated that a study reported in the Journal of the American Medical Association indicates that approximately 38 percent of Americans spend the last 10 days of their life in an intensive care unit in a hospital, and that 31 percent of families interviewed reported that they used all or most of their savings on end-of-life care for family members. He stated that a majority of adults prefer to be cared for in their own homes, yet nearly 75 percent of Americans die in a hospital or nursing home.

11:20 AM

Dr. Nowels provided an example of an individual he has cared for using palliative care. He spoke to the palliative care consultant's role. There was discussion regarding where and when it is appropriate to discuss end of life directives with individuals who are seriously ill. Dr. Nowels stated that he often acts as the primary care physician, as well as the palliative care consultant when discussing these types of questions with patients. He stated that often times, living wills do not address many of the situations that patients find themselves in.

11:40 AM

Dr. Nowels spoke to several different care models and how palliative care fits into the various models. He stated that one of the most effective care models is through multi-disciplinary teams, but the main problem with this model is that they are not be reimbursed within the current system. He stated that some hospitals have their own palliative care unit, or they contract with community palliative care centers. He stated that there is a high need for palliative care services in long-term care facilities. He spoke to the board certification for palliative care providers. He stated that there are about 75 slots nationally for training palliative care providers.

12:02 PM

The committee took a recess.