UCLA program offers care, comfort when all else fails
BY Enqrique Rivero
UCLA Today
With nothing else that doctors can do for Ellie Navi’s father, who was diagnosed with lymphoma three years ago, the focus now is on controlling his pain and keeping him comfortable.
To that end, Navi and her family have turned to UCLA’s Palliative Care Program, which aims to improve the quality of life for patients like her father, Alber Partiyeli, whose illness no longer responds to treatment. Besides controlling pain and other symptoms, the program focuses on patients’ psychological, social and spiritual needs.
Both patient and family have benefited, Navi said.
“We based our decision to move him to palliative care on Dr. Wallenstein,” said Navi, referring to program physician David Wallenstein, clinical assistant professor of family medicine at the David Geffen School of Medicine. “He’s like our coach — every step, he was there for us.”
Program staff assist patients in clarifying their goals of care. For instance, do they want more chemotherapy in the hope of reaching some attainable goal? Do they, for example, hope to attend their children’s high school graduation? “That’s the central core value — trying to identify and actualize the patient’s realistic goal for treatment,” he said.
Wallenstein estimates that the program, directed by Judith Ford, has helped several hundred patients since it was established four years ago, utilizing the efforts of doctors, nurses, social workers, spiritual care givers and others.
The team assesses a patient’s situation within the context of the family. Staff may help a wife arrange round-the-clock, in-home care for her husband or help the family of a patient on a ventilator who has left no instructions about whether he or she wants to remain on mechanical life support.
The team also works with the family to help resolve conflicts around the patient’s care goals. “I have one patient who has a number of children, and each has a different opinion on what to do,” Wallenstein said.
The palliative care team must also remain sensitive to a whole variety of cultural, ethnic and religious attitudes toward end-of-life care. “We have to be very sensitive to cultural variations,” Wallenstein said.
That sensitivity is reflected in the care Navi’s father has received. For instance, a staff member arranged for a rabbi to attend to his spiritual needs and is helping Navi decide whether to opt for hospice or in-home care. Navi said she is so grateful — and impressed — with it all that she is considering becoming a hospital volunteer.
“One day I’ll hopefully do something close to this,” Navi said. “Things like this really make a difference.”
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