Palliative Care Newsletter | Winter 2022
Wiener Family Palliative Care Unit Nurses Celebrate 10 Years of Exceptional Care As the Wiener Family Palliative Care Unit at The Mount Sinai Hospital celebrates its 10th anniversary, the dedicated nursing team was honored for the important role they play in the comprehensive, compassionate care delivered to patients and families in a staff celebration last December. Many of the unit’s nurses have worked there since its founding in 2011 and have earned advanced certification in palliative care nursing, demonstrating their commitment to persons with serious illness and their families. The palliative care nursing team is an integral part of the medical team, making daily rounds and
The Wiener Family Palliative Care Unit celebrates 10 years with dedicated nursing staff.
working closely to devise the best plan
care nurses, are the lucky ones because we
At the beginning of the COVID outbreak,
of care for each individual patient.
see the sweetness of life, the miracle to love
Ms. Alves-Miraldo created what she calls
Their medical opinions are sought and
and to be loved, and to dream, and hopefully,
a “resilience room.” She found a room
valued, and they are given the autonomy
to give our patients a better future.”
overlooking Central Park, brought in chairs,
to carry out the agreed-upon plans, which increases their confidence and morale, and makes them still more valuable to their patients.
One reason behind this team’s longevity is that, in addition to feeling valued, they say they feel supported. As an example, when they experience stress resulting from a
a recliner, curtains, a carpet, candles, and fragrant oils to give her fellow nurses a relaxing, quiet room where they can rest, eat, collect their thoughts, or write in a journal that she provided. “Everybody
Nursing can be a difficult profession in
patient’s condition, members of the larger
any field, but palliative care has a unique
Lilian and Benjamin Hertzberg Palliative
set of challenges. As much as they give,
Care Institute, perhaps including a social
Palliative care is specialized medical care
the nurses feel that they, too, receive
worker, massage therapist, and chaplain,
for people living with a serious illness. This
much from those they care for and from
visit the floor and help the nurses cope. Ms.
type of care is focused on providing relief
their chosen profession. “I think we have a
Alves-Miraldo cites the camaraderie among
from the symptoms and stress of the illness.
heightened sense of how to appreciate life,
the nurses, and is proud of the way they
The goal is to improve quality of life for both
and we really notice all the little things that
look after each other, switching days off and
the patient and the family. Palliative care
many people may just pass by or take for
covering for each other to accommodate
is provided by a specially trained team of
granted,” says Carla Alves-Miraldo, RN,
the needs of “our sisters” without
doctors, nurses, and other specialists who
MSN, CHPN, Senior Clinical Nurse and
compromising the care of their patients.
work together with a patient’s other doctors to provide an extra layer of support.
a 10-year veteran of the unit. “We, palliative B R O O K D A L E
D E P A R T M E N T
needs a little ‘me’ time,” she says.
O F
G E R I A T R I C S
A N D
P A L L I A T I V E
M E D I C I N E
Studying the Role of Caregivers and Quality of Life for At-Home Patients
Nursing Staff Members who have been with the Wiener Family Palliative Care Unit since its founding 10 years ago include:
Americans are living longer, as medical
makes a big difference. It matters for the
breakthroughs and improved diagnostics
person receiving care, and it matters for
and treatments enable health care
the family. Where there is a good paid
Denise Abraham
providers to treat and cure diseases.
caregiving situation in place, it’s really
Odunayo Akinola, RN
Although many live healthy, independent
life changing.”
Carla Alves-Miraldo, RN, MSN, CHPN
lives, a growing number of individuals have complex health care needs that require assistance by one or more caregivers. For those living at home, often this responsibility is taken on by family members. According to the Bureau of Labor Statistics, there are more than 40 million unpaid caregivers of adults ages 65 and older in the United States. Jennifer Reckrey, MD, Associate Professor in
Another goal of Dr. Reckrey’s research is to build an evidence base that helps the health care system appropriately value paid care, “not just because it’s the right thing
“It’s not realistic to think that families can handle this alone.”
the Brookdale
to do,” she says, “but because paid care is
Department of
essential for the health and well-being of
Geriatrics and
persons with serious illness.” She cites low
Palliative Medicine
wages, minimal training, and few pathways
Patrick Charles Joan Christopher, RN Keith Copeland Giselle Demorcy Tony Dodson Ed Franco Renee Gilbert, BSN, CHPN Jonathan Hernandez Krizia Ko, NP Luzviminda Lamagna, RN, CHPN Josh Lasseigne, BSN, RN, CHPN Ingrid Lockhart Lissette Marchi Yvette McLean Aglide Pierre Tina Tonogbanua, RN Zunilda Vargas, RN
at the Icahn School of Medicine at Mount
for advancement as evidence that such
Sinai, has been studying the role that
care is seen as unskilled and undervalued,
paid and unpaid caregivers play in the
which has led to a workforce shortage. She
health and well-being of at-home patients,
believes that policies should be put in place
including those with dementia, who require
that integrate medical care with direct care.
care. “When we talk about our medical
“Too often people are left to figure it out
care goals, long-term care is often left as a
on their own,” she said. “If we’re going to
side part of the conversation, but it’s really
support patients medically to stay at home,
Susie West, Chairwoman Emerita
central for people who want to remain living
we also have to think about how we’re
Deborah Berg
at home,” says Dr. Reckrey. “When we think
supporting those families who provide the
Jeannie Blaustein, PhD, DMin
about health care funding, we tend to focus
care and also supporting paid caregivers
Beth Dannhauser
on acute medical care, but caregiving is so
to make sure that care is high-quality and
important to day-to-day quality of life. The
accessible, not just for Medicaid patients
goal of my research is to shine a light on this
or people who can afford private pay home
and demonstrate that it matters.”
care, but to make it accessible across the
Daniel Rube
income spectrum,” Dr. Reckrey says.
Stephen Siderow
“It’s not realistic to think that families can handle this alone,” she continued. “A combination of paid and unpaid help
Lilian and Benjamin Hertzberg Palliative Care Institute Advisory Board Members Meryl Rosofsky, MD, Co-Chair Saskia Siderow, Co-Chair
Peggy Danziger Joseph Hertzberg David Mitnick Lois Perelson-Gross, DMin
Jennifer Steingart Zena Wiener
Social Workers Provide an Essential Component to High-Quality Palliative Care The mission of the
illness itself or from
Lilian and Benjamin
the side effects
Hertzberg
of treatment. We
Palliative Care
also offer support
Institute at Mount
of mind and spirit,”
Sinai is to provide
says
high-quality,
Mr. Palmer.
compassionate care for persons
Social workers
facing serious
advocate on
illness and their
behalf of patients
families. For these
and their families. They also have
individuals, there are many aspects
Jim Palmer, LCSW, Diane Farquhar, LCSW, Jacqueline Peare, LCSW
the training to
of care that go beyond medical diagnosis, prognosis, and symptom
sensitively facilitate family meetings, which can be especially helpful
and pain management which are important to their well-being.
when family dynamics sometimes add to an already stressful
Social workers play a crucial role in addressing many of the non-
situation. They may be asked to mediate family conflicts and clarify
medical, quality-of-life issues that affect patients and their families,
misunderstandings between patients, the team, and/or service
including goals of care planning, discharge planning, and family
organizations. They also help navigate the health care system and
communication.
can identify resources, both in the hospital and in the community,
The Hertzberg Institute social workers support the emotional and
that are beneficial to both patients and families.
practical needs of patients and their families, working as a team
In addition to working with patients and their families, Mount Sinai’s
with doctors, nurses, and nurse practitioners, licensed massage
palliative care social workers train third-year medical students on
therapists, and chaplains. Social workers begin their day with the
their palliative care rotations to teach communication techniques,
clinical teams to discuss their patients and their families. “No one
using role play so the students learn how to sensitively ask
clinician in our program works solo or in a silo alone, remote from
questions to identify a patient’s values and to answer questions
others. We’re interconnected as an interdisciplinary team,” says
that the patient or family members may have. Social workers also
Jim Palmer, LCSW.
do informal teaching with fellows (physicians who are training to
In addition to working with patients in the Wiener Family Palliative Care Unit, the social workers also do consultations in other areas of the Mount Sinai Health System hospitals, including the Solid Tumor
specialize in palliative medicine) and often accompany them into a patient’s room to reinforce communication concepts. In addition, they run weekly support groups for palliative care nurses.
Medical Oncology Service and the Surgical Intensive Care Unit or
“I know that I can’t change medical outcomes, but I can make things
wherever the need presents.
better for someone by advocating, by helping them process their
“Regardless of the prognosis, and especially if patients are pursuing curative treatment for their serious illness, we can shepherd them on a journey to provide symptom relief, whether it be symptoms from the
feelings, by working with their medical team so that they get sensitive care for their identity or their background,” says Diane Weg Farquhar, LCSW, ACSW. “That to me is very satisfying. We can make a difference.”
The safety of our community is our highest priority; some images in this newsletter were taken prior to February 2020.
Save the Date: The 25th Annual Douglas West Endowed Memorial Lecture “Seeing Ghosts and Making Change: How a Mother’s Passing Shaped a Writer and a Geriatrician” featuring Kat Chow, author of Seeing Ghosts: A Memoir and Stephanie Chow, MD, Assistant Professor in the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai. Monday, April 4, 2022, at 5:30 pm. Formal invitation to follow. To register, please visit: https://bit.ly/3zPGqgg. For more information, contact: Katherine.Brown@mssm.edu.
Kat Chow
Stephanie Chow, MD
Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a specially trained team of doctors, nurses, and other specialists who work together with a patient’s other doctors to provide an extra layer of support.
Lilian and Benjamin Hertzberg Palliative Care Institute Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place, Box 1070 New York, NY 10029 (212) 241-1446 mountsinai.org/care/palliative-care @MSHSGeriPalCare