Palliative Care
offers an extra
level of care to
patients and
their families


Palliative care focuses on relief from pain, the symptoms and the stress of serious illness to improve quality of life for patients and their families. It is a team-based approach, involving specialty-trained doctors, nurses, and social workers who work with the patient’s other health care providers to offer an extra layer of support.

While its beginnings trace back with the hospice movement of the 1960s, palliative care is not end of life care and can be delivered alongside curative treatment. “Palliative care is a combination of specialty of care providers, just like in cardiology and pulmonary and cancer specialists, it’s also a service and certain skill set,” explained Dr. George Giokas, chief medical officer of St. Peter’s Health Partners (SPHP) palliative care service line. “Essentially, it’s an extra layer of support for patients and their families that have a serious illness, working with your doctors. We aim to provide the best possible care.”

Palliative Care Team

The palliative care team is assembled depending on the patient’s needs, location, and situation. “The beautiful thing about palliative care is that it is not just one staff person or provider. It’s the amazing coupling of a nurse practitioner, physicians assistant, or registered nurse and also a social worker,” noted Catherine Markey, Social Worker. In the Capital District, Dr. Giokas and his team are embedded in local hospitals and physicians offices. Their goal is to be present when they are most needed: at the beginning of treatment. “We are involved in supporting patients at any stage of their disease trajectory but frequently at the onset, the first moment you are diagnosed with stroke, heart failure, or heart attack. That moment is optimally appropriate to introduce palliative care,” said Dr. Giokas.

For those outside the medical community, not much is known about this service to patients and their families. One area is long-term care. “Most illness that palliative care works with, and honestly, most illness that people have are not sudden events that you have, heal from, and then it’s all over with. That might happen with a car accident, but for most people with heart failure or emphysema, or most cancers, people were living with it for decades at some time,” Dr. Giokas outlined. He also outlined the “healing” process, noting that in the physical sense, healing is a role for physical therapists and their staff. A palliative team looks beyond the diagnosis to help patients live their best life while living with their disease. “People don’t get better by themselves; they are usually in a community our family that supports the healing process.”

According to the CDC, approximately 53 million Americans are currently serving as informal caregivers for patients with a variety of illnesses. The other aspect of palliative care is providing support to caretakers and family members by explaining the medical treatment and discussing stress areas. The daily demands of administering medications, accompanying the patient to physician visits, and preparing prescribed meals can lead to stress for family members and spouses, especially when they are trying to raise a family or care for themselves. Dr. Giokas acknowledges that part of the challenge is offering advanced care for a growing, aging population that has a wide spectrum of health problems. “It’s rare for us to treat just one condition, like heart disease. Patients often have a mild element of emphysema, COPD, diabetes, or arthritis. As a team, we work with the provider to treat all of the patient’s problems.”

The role of women as caregivers

Heart disease is the leading killer for men and women in the United States. Assitance and care will typically fall onto family members and spouses — most of whom are women. Studies show that more than 50% of women in America will care for a family member at some point during their adult lives. In a recent survey among California residents, 16% were serving as caregivers; of these, an estimated 59% to 75% were women, most of whom were married. Their average age: 51 years old. The strain of caring for a heart disease patient has recently been identified as an independent risk factor, putting the caregiver at almost 2-fold higher risk of coronary artery disease. “We can explore the ways to cope with that stress, whether it’s bringing in more resources from the community, additional family members to help, or working on long-term coping strategies that deal with the hard emotions of dealing with heart failure in your life,” Markey added.

In recent years, many states have created these cross-disciplinary task forces and passed legislation to educate providers and the public. For example, Vermont requires health care providers to demonstrate competency in identifying and engaging patients who could benefit from palliative care. In our area, very few patients ask for palliative care. Most referrals come from physicians when they discuss the role of a caretaker with family members. “I often hear from patients and their families how much time we spend with them. On average, it’s about an hour per visit. Our follow-up visits can potentially be just as long. We get to know them and ask questions on topics that they are not used to discussing in the medical setting. I often hear people saying that they don’t feel alone anymore when dealing with their illness; they feel like they have someone walking with them,” Markey shared.

For more information on palliative care options, please ask your doctor or health care provider at your next appointment.

Written by Michael Arce, Marketing Coordinator, Capital Cardiology Associates
Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.