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MEDICAL STAFF SPOTLIGHT Ask the Doctor: How would palliative care benefit my loved one?
Ask the doctor:
How would palliative care benefit my loved one?
Mark Stavas, MD, of Southeast Nebraska Cancer Center is a radiation oncologist who also specializes in palliative medicine.
Q: What is palliative care?
Palliative care is a comfort and support specialty for people with advanced or complicated illnesses. Essentially, it is a team based approach to optimizing quality of life and mitigating suffering. The goal of palliative care is to encourage individuals to live fully until their last breath.
Q: How is palliative care different from hospice:
Hospice is a subset of palliative care that is intended specifically at the end of life. In contrast, palliative care can occur at any stage of a disease and can be provided alongside curative treatment. For instance, many patients in our oncology palliative care clinic are receiving chemotherapy and radiation.
Q: What are common components of a palliative care clinic?
• A holistic approach to the stress of illness (physical, psychosocial, spiritual). • Assessment and treatment of pain and physical symptoms. • Psychosocial support for families and care givers.
Assistance with coping and decision-making. Advanced care planning. Assessing appropriateness for hospice.
Q: What are some common questions you ask your patients?
• What are your biggest fears or worries about the future? • If your health situation worsens, what is most important to you? • How much are you willing to go through for the possibility of more time? • Do you prioritize more time or more quality of life? • Is there any type of medical care that you would not want? • How much does your family know about your priorities and wishes?
Q: Where does palliative care fit into our current health care system?
The subject matter behind palliative care dates back to the origins of medicine and in a way reclaims the essence of what health care should be about: service to life. Over the past century, the medical enterprise has grown into a large, hard-to-navigate network of hospitals and payers. We have rewarded volume of care (performing procedures) over value or quality of care. In addition, we have become very effective at diagnosing and treating illness with a strong emphasis on mastery, while oftentimes leaving humanism and mystery behind. The healing experience has become disconnected and we have misplaced the language of ritual, grief and loss. At times, it feels like there are no limits unless you set them. In fact, the default in medicine is to do everything possible even if it doesn’t improve quality of quantity of life.
Palliative care looks at medicine through a different lens. We are focused on the person dealing with the disease, rather than the disease itself. Sometimes, we pump the brakes, step back and ask “does this treatment make sense based on your goals, preferences and individual definition of what life means beyond just breathing.”
It’s a way of redefining what matters most in the face of a serious illness without losing hope. It’s a way of finding simplicity on the other end of complexity.
Q: We’ve heard that you’ve incorporated music and videos into treatment and coping for your patients. How does this work?
After doing this work for some time, I’ve realized the importance of self-care, and that the threshold moments in life transcend words.
Sometimes philosophical ideas need to be experienced or lived through in order to be understood, and sometimes we need to lean into art, music, nature or poetry to make sense of the world around us.
While working in Nashville, I started a film company documenting the intersection of medicine and art near the end of life. Several of the films are online at www.pallidocs. com. It’s a way of showing rather than telling what palliative care looks like.
Q: What can you share about yourself?
I’m originally from Lincoln, but I’ve spent time in North Carolina and Tennessee. Before returning home, I was an academic physician at Vanderbilt Medical Center in Nashville, where I directed the pediatric and palliative radiation oncology service lines.
In my spare time, I am busy raising three young children with my incredibly patient and resilient wife. I have a strong passion for art and music and serve as a board member for Maple Street Construct, which is a creative-art workspace that bridges the gap between West Coast and Midwest artists. n
