By Dr. Karen Rudolph
Board of Directors
When I was asked to write an article sharing my perspective on palliative community care, I realized my reflections on the topic are bittersweet.
As an internist and geriatrician who worked in our community for 35 years before my retirement in 2020, I took care of many patients living with one or more serious illnesses. I saw these patients get sicker over time, often needing repeated hospitalizations to manage symptoms and becoming more dependent on their families for help. Some even had to enter nursing homes because of a lack of appropriate home care. I often felt sad or frustrated because a palliative program, which could have helped many of these patients and their families, was not then available in our community.
As examples of those who could have received benefit from palliative care, I remember elderly patients hospitalized for heart failure or respiratory complications from COPD who seemed stable at the time of discharge but whose condition unexpectedly changed. This often was before they could be seen back in my office for medication adjustment to prevent them returning to the ER or needing re-hospitalization. Others, who were having difficulty with control of symptoms, were sometimes found to be taking medications incorrectly as a result of confusion about directions. Or they experienced unrecognized side effects, or they may not have taken the prescribed medications at all because they couldn’t afford the medicine.
Just a little over a year ago, after extensive planning and preparation, Hospice of the Panhandle became able to offer a palliative care service to West Virginia residents of Berkeley and Jefferson counties. This was the result of a generous community donation – an estate gift from the late Earl and Marie Snyder. The funds from this gift allowed staffing of the program with highly qualified medical professionals.
Panhandle Palliative Services began by accepting only patients with cardiac or pulmonary disease diagnosed but soon expanded to offer services to anyone living with severe illnesses. The program provides home visits from a nurse practitioner, and social worker, if needed, for patients. Another interesting fact about Panhandle Palliative Services is that enrollment in the program does not require a patient to forego life-extending treatment, such as chemotherapy or dialysis, which is different from eligibly requirements for a hospice program.
The palliative team members communicate and coordinate care with the patient’s primary care provider and/or specialists. Management of symptoms to help patients avoid frequent ER visits and hospitalizations and to maintain comfort and quality of life are goals of the program. The program also helps connect palliative patients and their families with community resources. Phone support for urgent needs or questions is available 24/7.
So my fervent wish for a community-based palliative care program became a reality…just as I was retiring from active medical practice. I am sad I could not offer this program to patients under my care who could have benefited but also very happy that it is now available and has potential to grow and provide help for many more people in years to come.
Dr. Karen Rudolph retired from WVU Internal Medicine in 2020. She is a member of the Board of Directors of Hospice of the Panhandle and serves on the interdisciplinary team for Panhandle Palliative Services. If you think you or a family member may benefit from Panhandle Palliative Services, call (304) 264-0406 for more information, or ask your health care provider for a referral.