Palliative care aims to improve the quality of life for those with serious illnesses by treating physical, psychological, and spiritual pain and symptoms. It takes an interdisciplinary, whole person approach involving physicians, nurses, social workers, chaplains and other practitioners. As the population ages and chronic illnesses rise, palliative care can help address the inadequately treated symptoms, fragmented care, and strains on family that many serious illness patients experience. While palliative care programs have expanded in hospitals, continued growth faces barriers in workforce shortages, lack of research funding, and reimbursement challenges.

1. Palliative
Care
Definitions and
Opportunities
Chaplain Ted Taylor
Fellow in Hospice & Palliative Care

2. What is Palliative Care?
 VIDEO: “You are a Bridge”
 https://youtu.be/lDHhg76tMHc

3. Improves Quality of Life
 Treats people suffering from serious and chronic
illnesses
 Focuses on symptoms such as
 Physical pain
 Shortness of breath
 Fatigue
 Constipation / Nausea / Loss of appetite
 Difficulty sleeping
 Depression and other psychological distress
 Emotional pain
 Spiritual pain

4. Improves Quality of Life
 Helps people gain the strength to carry on
with daily life
 Improves the ability to tolerate medical
treatments
 Helps people have more control over their
care by improving their understanding of
treatment choices by considering the
goals of care

5. A Partnership of Care
 An interdisciplinary team approach
 Physician
 Nurse
 Social Worker
 Chaplain
 Pharmacist
 Dietitian
 Other practitioners / therapists

6. A Whole Person Approach

7. The Case for Palliative Care
 90 million people in the US are living with
serious / life-threatening illness
 This number will double in the next 25 years
 Most people living with serious illness
experience
 Inadequately treated symptoms
 Fragmented care
 Poor communication with practitioners
 Enormous strains on family caregivers

8. Growth & Barriers
 In 2001 almost no hospital-based palliative
care programs
 By 2011 63% of hospitals with 50+ beds
have a palliative care team
 Barriers to continued expansion
 WORKFORCE
 RESEARCH
 REIMBURSEMENT / INVESTMENT

9. Workforce Barriers
 Lack of trained physicians nationwide: 1:1,200
palliative care doctors
 1:71 cardiologists
 1:141 oncologists
 A new specialty (formally recognized in 2007)
 No Medicare funding for training due to cap
on GME expansion
 Increasing demand for nurses, other clinicians
certified in palliative care

10. Research
 Funding (NIH, Institute of Medicine) for
palliative care research not keeping pace
with the growth of the discipline
 Need to strengthen the knowledge base
supporting clinical practice

11. Access & Quality
 Business model based on cost avoidance,
not revenue generation
 Accreditation standards only just
beginning to require palliative care

12. Our Unique Opportunity
 Dartmouth Atlas Study
 NJ has the most aggressive & costly care at
the end of life than any other state
 Studies show higher utilization correlate
with
 Lower patient satisfaction
 Poorer clinical outcomes
 60 Minutes report: “The Cost of Dying: End
of Life Care” (August 2010)

13. EOL Planning
 Advance Directives (“5 Wishes”)
 Healthcare Proxy
 Living Will
 POLST