Abundant life Palliative Care Program
Abundant Life Palliative Care Program is a pilot program, and has been in existence for over a year with fantastic results.
To explain a bit more on what we are and what we do, palliative care is defined as medical specialty focused on relief of the pain, stress and other debilitating symptoms of serious illness.
Doctors’ aim is to cure patients, but sadly, that is not always possible. Often, certain patients simply require care. It is important that health care providers recognize that stage, and provide the necessary care in order for their patients to be as symptom free as possible in their last days. At this point, the greatest treatment that can be provided to patients and their families is open communication about death and their condition. The lack of this communication so often seen in society is a barrier, and creates the false impression that hospitals are places where people come to die. Victoria Hospital’s Abundant Life Program aims to change this perception by providing care (physical, psychological, and spiritual) and autonomy to each patient as they walk through the end of life stages.
Why is it beneficial to have a palliative care program at Victoria Hospital?
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According to available Mortality and Morbidity statistics, 48.8% of Victoria Hospital patients die from predicted unavoidable causes. The Abundant Life Program has been implemented to ease the suffering and increase the quality of care for these patients. Anecdotal results have shown an overwhelmingly positive response in reference to increase in quality of care, and both patients and family members are extremely happy with the program.
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Each year, approximately 683 beds are taken by admissions of regular revolving door patients. Abundant Life statistics have shown that our palliative care project decreases the number of admissions per month in the three months prior to death from approximately two visits to less than one visit when enrolled in the program. This allows hospital beds to be used by acute patients with curable problems, and also is a source of cost savings for the hospital.
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The most common recurrent avoidable admissions can be grouped into two types of patients: organ failures, and elderly frail patients. Our program aims to ease the suffering of these patients, and to provide them with the ability to make their end of life stages as positive as possible. This can be done in many ways, but a salient outcome of our program is percentage of people who have the chance to die at home instead of in the hospital.
Organ failure patients represent approximately 683 patient deaths at Victoria Hospital per year. This number is steadily increasing as well. These patients experience a much more steady decline over years with acute exacerbations, often requiring hospitalization, with an unclear terminal phase leading to death. There is difficulty predicting which acute exacerbation will be the patient’s last, so in the final days, death may come as a shock with little preparation beforehand by the patient, family, and staff. These patients often miss out on end of life benefits given to HIV/AIDS and cancer patients who have a more predictable decline. However, the Abundant Life Program aims to predict which organ failure patients are nearing end of life, and aims to provide these end of life services to patients. Predictive indicators, such as those found in Karnofsky prognostic indicators and Barthel’s index, are used to locate possible patients, and by raising awareness of these patient’s needs, more can be done to enable good palliative symptom control, career support, respite, and life closure discussions for these patients. As organ failure patients often experience a slower overall decline, supporting care through palliative care at an early stage is important to enable a patient to live well until they die.
Frailty and dementia patients are prime candidates for the Palliative Program as well, as this group consists of elderly patients often with multiple organ failures, cumulative co-morbidities, and frailty. These patient’s needs are different from the traditional cancer patients, requiring more long-term community support, support for carers, and less emphasis on institutionalization. Their end of life stories may be equally important, and often at times less well voiced.
Out multi-disciplinary team of doctors, nurses, occupational therapists, physiotherapists, social workers, and volunteers provides daily care and support for our patients, and three bi-weekly sessions where a different aspect of their disease is emphasized. The first week concentrates on the patient’s diagnoses, explaining in detail to the patient and to family what exactly our program is, and what the disease will entail. The second session revolves around the occupational therapists and physiotherapists, allowing them to work with the patients to help them become as mobile and autonomous as possible. The third session focuses on the social workers who help patients and families with placement if needed, or with needed grants. Our program has a holistic goal, and attempts to reach this goal with multiple facets of physical, mental, and emotional care.
