Coffee Conversations: How palliative care can provide extra support amidst serious illness

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Forge recently sat down with Dr. Rodney Tucker for an episode of Coffee Conversations on palliative care. Dr. Tucker received his medical degree from UAB and completed his master’s in medical management at the University of Southern California. He is board certified in internal medicine and palliative care. With his educational background and experience in private practice, home care and hospice services, he has actively assisted UAB in the development of comprehensive clinical and research programs in palliative care. As a current director of the UAB Center for Palliative and Supportive Care, he has also been active within the Southeastern Institute for Innovation in Palliative and Supportive care at UAB. We’ve recapped the highlights below, but if you have a few minutes be sure to check out his full interview by clicking here.

What is palliative care?
Dr. Tucker explains that the co-term of palliative care is “supportive care.” Palliative care is a specialty of medicine that has recently been developed within the past 20 to 21 years. This type of care focuses on providing patients and their loved ones with services that cater to what Dr. Tucker calls the five domains. These domains include the physical, emotional, psychological, spiritual and cultural aspects that makes us human.

Palliative care specializes in treating patients holistically and emphasizes working as a team. This team includes social workers, psychologists, nutritionists, counselors, physical therapist, massage therapist and different types of expressive therapy. Additionally, patients are commonly seen alongside curative treatment.

The word palliative comes from the Latin word pallium. This refers to the robes worn by the popes of the Catholic church; the robes were meant to protect them from evil.

What is the difference between palliative care and hospice?
Hospice is an insurance benefit program that is designed for patients who are entering their potential last six months of life if their disease holds it natural course. Dr. Tucker further explains that hospice allows patients to spend the rest of their life comfortably at their home or in a home-like setting. It pays for nursing care, medical oversight, medicines related to symptoms, oxygen and all the things needed to take care of them in their home. It is important to note that patients can “graduate” from hospice if their symptoms are under control. Palliative care on the other hand can be done at any stage of a serious illness; it is not restricted to six months.

When is it the right time to consider palliative care after learning about a serious illness?
Dr. Tucker suggests that its best to consider palliative care when the patient and the family feel like there is some aspect of life that is not right. Patient’s might feel like they are missing something or their quality of life is being impacted. This decision and process is individualized and looks different for everyone; there is no cookie-cutter way to engage in palliative care.

What is the first step someone needs to take to take advantage of palliative care?
“The first checkpoint is checking in with yourself and family,” said Dr. Tucker. “What are you seeing?”

Letting your chosen family know what you’re experiencing is vital. Checking in with your closest medical professional and asking them what they’re observing is also key. Think about your goals and what you may want to improve.

Dr. Tucker explains that the biggest barrier is access. However, if you have hospital admission, it is easier to have a consultation. Additionally, telehealth consultations also have helped with accessibility.

Are there any other resources that patients should be thinking about prior to making the decision to participate?
A helpful resource is the website getpalliativecare.org. This website has a list of resources and frequently asked questions. It is important to know that most insurance companies cover palliative care services, however, some services may require insurance approval. This could include counseling services, nutritional services, physical therapy or massage therapy. Although insurance approval may be required, it should not be a problem to see a palliative care specialist. In both an outpatient setting and hospital setting, a patient does not have to have a physician referral to have access to palliative care resources. Dr. Tucker emphasizes that allowing the patient to feel human is what’s the most important; as we enter different parts of our journey, we do not need specific parameters because our bodies and goals are all different.

Any last thoughts?
“The specialty of palliative supportive care is about quality of life, and treating patients in a holistic manner,” said Dr. Tucker. “If I am diagnosed, I want to be cured, healed, listened too, have good quality of life and a family of choice along with me.”

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