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Palliative care "walks alongside" patients fighting serious illnesses

Miami Herald photo

@patriciaborns  Marlin Shaw turned gingerly on her side to lessen the pain in her lower spine that even morphine couldn’t relieve. While the 43-year-old Fort Lauderdale mother of three waited in her hospital room to be wheeled to radiology, she worried about her daughters who haven’t accepted the end-stage cancer she was diagnosed with last year.

“They haven’t voiced it, but I know they’re scared,” said Shaw, a Medicaid patient at Broward Healthwho has braved aggressive therapies to buy more time with them. What keeps her going, she says, are the doctors, registered nurses and social workers of the hospital’s free palliative care program.

Unlike hospice, which cares for people in the last six months of life but often requires them to give up curative treatment for Medicare or Medicaid coverage, palliative care begins at the first diagnosis of a potentially life-threatening illness, helping people manage pain and symptoms so they can live normal lives outside hospitals, sometimes for years.

Programs like Broward’s aim to keep patients pain- and symptom-free as they go through chemotherapy and other demanding regimens. Broward Health, one of the nation’s largest public hospital systems, offers palliative services to all its patients, including those with low incomes like Shaw.

“We call it ‘walking alongside the patient,’ ” said Dr. Pamela Sutton, who launched the program in 1994. It was South Florida’s first.

Sutton, 65, started palliative care at Broward after working for the World Health Organization in countries where medications were lacking. “If you could get some morphine, it was actually possible to have a life,” she said.

Walking alongside Shaw, initially meant helping her transfer from a hospital that lacked palliative care.

For much of the past year, Sutton and Dr. Ravi Samlal, Broward Health’s eighth palliative care doctor in training, managed Shaw’s symptoms with opioid and non-opioid analgesics — painkillers — allowing her to remain at home.

When her cancer made the pain in her upper spine unbearable, the team asked Shaw’s oncologist about using radiation to shrink it. It worked: the pain lessened. With a walker and wheelchair to get around, she returned to her family.

Patients like Shaw, who are seriously ill, account for only 10 percent of the population but more than 50 percent of healthcare costs, according to the U.S. Dept. of Health and Human Services. Palliative care is less expensive than keeping them in hospitals. Since Sutton launched the practice at Broward Health, about half of all U.S. hospitals have added similar services. Read more.




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