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Week of April 1, 2013

Program to help train next generation of palliative care providers

Helen Snow had just returned home from hiking in the Appalachian Mountains when she experienced sudden symptoms of a condition that ultimately would require reliance on an oxygen tank.

The onetime active pet groomer, dog show competitor and gardener eventually was diagnosed with dermatomyositis (DM) — a rare autoimmune disease that attacks the body’s muscles — and non-specific interstitial pneumonitis. It meant overwhelming fatigue, shortness of breath and chronic pain.

After three years of undergoing treatments that didn’t work, Snow is at the U-M Health System’s palliative care clinic where she finds help managing symptoms to help make her life as comfortable as possible.

“This illness has completely diminished my quality of life,” says Snow, 57, of Farmington Hills. She had to quit her job and give up her home after getting sick. “When I got here, they told me, ‘You don’t have to hurt. We are here to help.’”

It’s the kind of care UMHS hopes to expand with the start of a new academic Adult Palliative Medicine Program that would aim to increase the number of physicians specifically trained for palliative medicine. The program will expand clinical care, education and research opportunities related to adults with chronic debilitating disease, and poise the institution as a national leader in the emerging field of palliative care.

Palliative care focuses on relieving and preventing suffering for patients at any stage of an illness, and includes the management of physical and emotional disease symptoms. Patients may be undergoing treatment for curable illnesses, living with chronic diseases or nearing the end of life.

“The goal of palliative care is to provide relief from symptoms, and stress of a serious illness ­— whatever the diagnosis,” says Dr. Raymond Yung, chief of the Division of Geriatric and Palliative Medicine in the Medical School.

“The new APM Program at the U-M Health System is a pivotal step in our commitment to support these patients through their disease, whether they need new pain remedies, help making difficult medical decisions or emotional guidance.”

The new program unites palliative medicine specialists, nurses, social workers and many others from across the Health System and campus, focused on addressing physical, emotional, spiritual, and social concerns that arise with advanced illness. The program is expected to enhance UMHS’s existing Hospice and Palliative Medicine fellowship program, foster new research and philanthropic opportunities and help form new clinics focused on palliative care.

“Building on the expertise that exists through the Health System and the schools, our new palliative care program is devoted to helping patients with serious illness live longer and more satisfying lives,” says Margaret Calarco, chief of nursing services.

The new structure will include representation from the Department of Internal Medicine, the Department of Family Medicine, the School of Nursing, the School of Social Work, and the School of Pharmacy.

“We are building on over a decade of strong, interdisciplinary commitment to high quality palliative care at UMHS,” says Dr. Phillip Rodgers, assistant professor of family medicine. “We have seen the difference it has made in the lives of thousands of patients and families we’ve worked with in our hospitals, and a growing number in our clinics.”

The palliative medicine team works together to create a comprehensive plan of care for patients. Examples of palliative care may include helping a patient recover from an illness by easing symptoms such as pain, anxiety or loss of appetite during surgery, chemotherapy or other procedures. Palliative care also may help patients transition to home after being released from a hospital or nursing facility.

“This program will allow us to train the next generation of palliative care providers. As our population ages and more people are living with chronic disease, the need for effective and timely palliative care interventions will only increase,” says Dr. Adam Marks, co-director of the Palliative and Supportive Care Clinic at the East Ann Arbor Health and Geriatrics Center.

The Health System also has outpatient palliative programs at Chelsea Family Medicine and the Supportive Care and Symptom Management Clinic in the Comprehensive Cancer Center.


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