MD Anderson OncoLog, Volume 43, Number 7, July 1998 Page: 2
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Palliative Care
(Contin ued from page 1)"The philosophy of integrated
palliative care is part of cancer
treatment overall."
This is demonstrated by her work
incorporating palliative care within
the collaborative care paths as they
are drawn up by the M. D. Anderson
Practice Outcome Programs.
But when disease advances to an
incurable stage, Weinstein says the
emphasis shifts and the array of
services widens. Consultative special
services include help with symptom
control, psychosocial and spiritual
support for patient and family, and
consideration of advance directives.
"We help patients look ahead-to get
the most out of the time they have
left," Weinstein said.
When the prospect of living
narrows to six months or less and
treatment with curative intent stops,
patients can make a transition to
hospice care, if they choose.
"Hospice is a philosophy of care,
not a set of interventions or a place,"
Hospice Eases Pain,
Fear at the End of LifeWeinstein explained. She said it was
the recognition that a specialized
type of care was demanded at the
end of life that created hospice care.
"The word hospice, "she said, "means
'way station for travelers."'
Dr. Weinstein and her colleagues
work with terminally ill patients who
are not eligible or not interested in
participating in a research protocol
to identify the best care plan at this
point. More than half return home,
and the others continue receiving
care at M. D. Anderson or choose to
enter a dedicated hospice facility,
such as the Hospice at the Texas
Medical Center, which Weinstein
called "exemplary."
Weinstein states it is essential to
help patients and their families
evaluate the issues at this traumatic
period, including care setting,
continuity of care, and proximity to
family and friends. She said transi-
tions require special attention to
feelings of disruption, of beingabandoned by physicians, and of
being in an unfamiliar setting.
"Nurses and physicians work hand-
in-hand around the patient's and
family's needs," said John D. Crossley,
R.N., Ph.D., associate vice president
for patient care operations and head
of the Division of Nursing. Dr.
Crossley describes palliative care's
"special nursing dimension" as
providing comfort and acceptance.
He said there was a strong emo-
tional aspect to choosing hospice
care. "For some patients, hospice
represents giving up. Others reach a
stage of acceptance and understand
hospice care to be the best treatment
available to them. We work closely
with the TMC hospice for patients
who live in Houston. We work with
other hospices in Houston and out
of state as well-whatever suits the
needs of the patient and family,"
he said.
For those who choose home care,
M. D. Anderson can provide referrals toPorter Storey M.D., I )
remembers a patient in
his 40s who had bilat-eral lung cancer when he was
referred to the Hospice at the
Texas Medical Center The
man was so short of breath and
miserable when he came to the
hospice that he just wanted his
life to be over: "Kill me, doctor"
he told Dr Storey.
Some days later, the day before
he died, the patient was outside on
a blanket in the garden enjoying a
picnic with his family. The nurses
had run a line out the window that
delivered oxygen through a mask.
The patient lifted his glass and said,
"Doc, this is really living."
"When we help patients getDr Porter Storey stands near the lily pond on
Medical Center
comfortable and gain peace of mind,
they are able to find meaning and
hope in the context of their lives,"
explained Dr. Storey. "They are able
to see dying as part of a full life, letthe grounds of the Hospice at the lexas
go of lots of the fear, and finish
their lives with a sense of comfort,
control, and completion."
Dr. Storey, vice president for
medical and academic affairs at2 / MD Anderson OncoLog
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University of Texas M.D. Anderson Cancer Center. MD Anderson OncoLog, Volume 43, Number 7, July 1998, periodical, July 1998; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth902771/m1/2/: accessed April 26, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.