Goal is to enhance life, empower those with serious disease
Learning that you or a loved one has a serious or life-threatening illness can be terrifying. But referral to palliative care services should not be, says the physician who has led the groundbreaking Palliative Care program at Parkland Health & Hospital System for 20 years.
Adelfa Lorilla, MD, of Seagoville agrees. “Even health professionals can feel overwhelmed when providing care for a family member,” she said. A pediatrician in her native Philippines, Dr. Lorilla is now full-time caregiver for her husband Ricardo, 67, who is gravely ill with COPD.
“The Palliative Care staff at Parkland has given us so much help and comfort for the past two years,” she said. “They make sure we have everything we need and are like family to us.”
“What I find is that people are most afraid of the unknown,” said Elizabeth Paulk, MD, Medical Director of Palliative Care at Parkland and Program Director of the Palliative Care Fellowship Program at UT Southwestern Medical Center. “Information presented in a straightforward and realistic way is very helpful when dealing with a new and frightening situation. What we tell patients is, ‘Don’t be scared. You’re not alone. We’ve walked this path before and we’re going to walk it with you.’”
Though they work closely together and are often confused in the public’s mind, palliative care and hospice programs are not the same. Palliative care provides patients relief from the symptoms, pain and stress of a serious illness, regardless of the diagnosis or stage of illness, and can be combined with curative treatment. The goal is to improve quality of life for both patient and family. Hospice offers supportive care to people in the final phase of terminal illness.
“Palliative care focuses on control of symptoms, like pain, fatigue or shortness of breath and also addresses the emotional, spiritual and social needs of the patient and their family,” Dr. Paulk explained.
“People have to remove the idea that palliative care will be the end of everything for them,” said Dr. Lorilla. “No, it is here to help you live longer and better. We are very thankful for them.”
Dr. Paulk has dedicated her career to providing patients with limited financial resources the highest possible quality of palliative care.
“One of the most important things we do is give patients more control over their care by helping them understand their treatment choices. We don’t just provide pain management. We meet the patient where they are, psychologically as well as physically, and work with their medical specialists like oncologists or cardiologists, to help the patient live as well as possible and to help them make good choices about their care.”
The team arranges for hospice care when needed, and stays in touch with patients and family members during final stages of illness. Parkland offers a bereavement program and grief support groups in English and Spanish for family members.
Started in 1999, Parkland’s Palliative Care program was one of the first in the state and remains one of the largest in Texas and the U.S. In FY 2016, the program had 3,324 patient encounters in outpatient and inpatient units at Parkland Memorial Hospital. The Palliative Care Clinic operates five half-days weekly and inpatient consult services are available by phone 24/7.
Working in one of the nation’s largest safety net hospitals, Dr. Paulk and her team assist patients ranging from age 18 to over 100 and of many ethnicities. Approximately one-third of patients are Hispanic, one-third African-American and the remainder of Caucasian, Asian or other backgrounds. Most have been diagnosed with cancer, heart failure, COPD, renal or liver disease.
“One of the things I am most proud of is that we provide very culturally sensitive care,” Dr. Paulk said. She and most members of the team speak Spanish. Providers include nurse practitioners, social worker, chaplain, psychologist, pain management specialist, pharmacist, physical therapist, bereavement coordinator, medical assistants and others. Online interpreters are available as needed for the many languages encountered among Parkland patients.
Regardless of language spoken, the message from Dr. Paulk and the Palliative Care team is the same. “This is about life – how you want the rest of your life to be and how we can help you get that.”
“Spirituality plays a major role in how many patients deal with illness and dying,” Dr. Paulk said. “We are very humble about the reality that we as medical professionals speak from a scientific perspective. Our approach to treatment is to help anyone who is trying to live well in the face of serious illness and to keep them as healthy as possible. We know we don’t have control over everything.”
During her years helping those with serious illnesses, Dr. Paulk has observed that people “have better total health and live longer because of the support of family and friends, because they stay engaged and have a relationship with the world and feel gratitude even in the face of adversity.”
”Parkland should be proud of Dr. Paulk and her team,” Dr. Lorilla said. “You know in their hearts they truly care for you - spiritually and emotionally as well as physically.”
“I have the best job in the world because I get to help people feel better,” Dr. Paulk concluded.
To learn more about Parkland services, visit www.parklandhospital.com.