For most people, a trip to their medical provider solves most medical concerns. But what if that trip is too difficult to make or what if the provider wants to address some other concerns, so a visit to the home becomes necessary. That is when palliative care comes into play.
While most larger communities offer a form of home health care and hospice care, not all are bridging the gap between those two and offering what is called palliative care. But Cut Bank is and, for now, a few select patients have the option to receive that type of care.
Palliative care has been part of Glacier Community Health Center’s strategic plan for a number of years. Funding, however, was “illusive,” as Marsha Atherton, M.D., put it until recently.
Dr. Atherton knew this type of care was necessary and needed in Cut Bank, especially since there is no hospice care at home and no regular home health care either.
So, what exactly is palliative care? How do you know if you or a loved one need it or not? And are you eligible?
Dr. Atherton explained the answers to those questions.
“Palliative care is often confused with home health and hospice care, but it is very different,” explained Dr. Atherton. “Palliative care is the type of care that bridges the gap between care received in the clinic and hospice care, which can either be received at home or in a hospice care facility. It can be an in-home care for a chronic-type illness that has limited the patient’s quality of life.”
She continued, “While our program is completely home-based, palliative care as a discipline, can occur in the home, in a hospital, or in a structured care facility such as a nursing home. Palliative care offers symptom relief and hopes to improve the quality of life for the patient.”
The only patients currently being seen in the program are those that are actively seeing a current GCHC medical provider or behavioral health provider.
“We know that there will be a number of patients in Cut Bank that would like to be part of this program, but for right now we are only taking referrals from our own providers at GCHC. We know these patients and can help make the decision on whether or not this program will be right for them, because it isn’t for everyone. As we start the pilot phase of this program, which will last for six months, this will be our phase one group of patients,” Dr. Atherton pointed out.
When additional phases are put into place with the program, it is very likely another group of patients will be seen that are not just GCHC patients. However, they will still need a provider referral and a proper diagnosis before they can be added into the program.
Dr. Atherton provided one type of diagnosis that might make the patient an acceptable candidate for the program and that would be congestive heart failure. However, not all patients who have been diagnosed with this condition, are candidate. Only those patients whose quality of life has been diminished because of the diagnosis would be considered for this program.
“Many patients have a different degree of illness with a single diagnosis, making some of those patients with, say, congestive heart failure fully functional and others who are not. If they are fully functional, that would mean they are not the kind of patients for this type of in-home care,” said Dr. Atherton. “Whether they can be part of the program will be up to them and their provider.”
Once it is determined a GCHC patient could be eligible for this program, there will be an in-home assessment done and that will involve one, two or possibly up to four people. Because this type of care integrates with the behavioral health side of care too, part of the team that comes to the home will be behavioral health specialists.
The team seeing patients includes, Joseph Shollenbarger, N.P.; Laurie Wynn as the support medical person and phlebotomist; Angela Black, LCPC; Behavioral Health Director JR Myers and Toni Costello, who is the care manager.
“They will go to see the patient, spending time in the patient’s home with the patient and learning how the patient lives and functions in their home,” Dr. Atherton said. “Our care has usually been that the medical side does this for care and the behavioral health side does that for care. With palliative care, it is more of an integrated program where the patient has specialists from both sides of that level of care seeing them and assessing them.”
Dr. Atherton admits this is a new way of thinking about patient care and will undoubtedly help providers and the team of care specialists seeing the patients, provide the patient with the proper form of care.
She added, “I am cautiously optimistic about the program and am excited to get it started. We had plans to start this much sooner, but then COVID-19 hit and everything had to be put on hold until it was safe to start.”
The program is being funded through an Integrated Behavioral Health grant through Health Resources and Services Administration (HRSA), which is an agency of the U.S. Department of Health and Human Services If the program is successful, this grant will be then rolled over into GCHC’s regular grant from HRSA.
“The seed money to start the palliative care program came from the grant money we receive from HRSA funds, which funds the operations of our clinic,” said Dr. Atherton. “We have to prove to them we can make this program successful and we have every intention of doing just that.”
Dr. Atherton concluded, “It is our hope that this level of care will allow the patients to remain home longer before needing a higher level of care.”