Palliative Care at Mount Sinai

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