`Palliative care': A warmer touch.

Byline: YOUR HEALTH By Denise Waugh The Register-Guard

There is a new phrase being heard more and more often in medical circles: `palliative care.'

Not to be confused with hospice or `end of life' care, palliative care is a branch of medicine dedicated to relieving suffering and promoting the best possible quality of life for patients and their families, regardless of the stage of serious illness or the need for other therapies.

It is an organized and structured system for the delivery of medical care, a philosophy of care that can suffuse an entire organization.

Palliative care is the newest medical subspecialty, having been granted that status by the American Board of Medical Specialties in 2006. It is supported by 10 other medical specialties - including internal medicine, family practice, pediatrics and radiology.

So why was there such widespread support for yet another subspecialty of medical care? Don't doctors, nurses and hospitals already care about their patients? Haven't they always done everything possible to cure what ails us?

Part of the answer is that palliative care provides balance to the rapid and relentless advance of medical technology. Although palliative care is certainly not opposed to high technology, in some ways, it is a return to more basic values. And in a world of 10-minute office visits, it is a return to communication.

Medical care in the 21st century is a high tech affair. Every branch of medicine is struggling to keep up with rapid advances in drug therapy, surgical techniques and treatment options. Hospitals and insurers are faced with ever growing record keeping, privacy and regulation and restrictions imposed by government agencies. There is not always time to remember that the patient is also a person, to recognize that while the patient is in the hospital for a physical ailment, that person has social, cultural, psychological and spiritual needs.

Palliative care recognizes and addresses those needs. In many ways, it is the `high touch' answer to high tech medicine. It helps patients set goals, coordinate care and understand the complex medical system.

Serious illness often erodes the comfort, dignity and control of the patient and family - the very qualities that people say make their life worth living. Palliative care aims to ease suffering and promote quality of life during all stages of an illness. It recognizes that suffering is not merely physical. Suffering has physical, psychological, social, cultural and spiritual aspects.

Ideally, palliative care is provided through a team approach to maximize the collective wisdom of the team members and improve quality of life - regardless of life expectancy. Working with a team of social workers, chaplains and nurses, the palliative care physician may serve in consultation with the patient's doctor or may, on request, assume primary care responsibility.

Palliative care recognizes, as pediatrics has for years, that family is a critical component of care. Family in this context refers to those the patient holds dear and those whose lives are most affected by the patient's illness.

Palliative care acknowledges death while affirming life. It helps the patient and the family to understand the benefits and the burdens of each treatment and to adjust the plan of care based on the patient's changing condition.

Symptom management may include:

Intensive medication therapy.

Relaxation techniques, such as massage and guided imagery.

Complementary therapies such as aromatherapy, acupuncture and acupressure.

Assistance with emotional and spiritual needs to help in understanding the illness and its deeper meaning to the patient and family.

Help with development of coping skills and support for the patient and loved ones.

Palliative care is based on the premise that healing can occur throughout life, even when all hope of cure has passed.

Locally, American Board of Hospice & Palliative Medicine certified physicians include Drs. Lisa Adams, Leo Cytrynbaum, Joseph Scott Dunn, Sharon Flynn, Stephanie Jocums, Stewart Mones, Libor Pavlosek, Johnnie Riggs, Jennifer Soyke and Denise Waugh.

In addition to her certification in palliative medicine, Dr. Denise Waugh continues to practice emergency medicine at McKenzie-Willamette Medical Center, as she has done for more than a decade.