In 2011, my husband’s cardiologist reported, “Good news, Bill: PeaceHealth has hired a palliative care specialist.” The downside was the services were in-patient only. To reap the benefits required hospitalization.
Bill had decided to forgo all further advanced medical interventions for his incurable congenital-induced heart disease. He received “one-man” palliative care from his cardiologist for years, which kept him out of the hospital. When he died in 2013, I committed my time and efforts to raise awareness about this urgent need, coupled with advance care planning.
To sustain the momentum on ACP and increase access to outpatient palliative care, health care systems must expand the reach of palliative care professional expertise outside of end-of-life care. The basic skills required to deliver a palliative approach must be provided for all staff in health care settings for people with chronic illnesses. Will the small cadre of trained palliative care specialists already in practice spend more of their time teaching and mentoring? There is still resistance to upstream palliative care by some clinicians — and many employers.
The time is here for a substantial shift in the way health care is delivered. It would be irresponsible not to change — the sooner, the better.
