Thursday, February 14, 2013 - Guidance for Making the Hard Decisions - Palliative Care Program Helps

When faced with a serious illness, what kind of medical care do you really want? If left up to you, would you opt for the same care that your family would choose for you? If Dad could not speak for himself, or your teenager were in a car accident, would you know their wishes? If not, how do you make the right decision?

Many important care decisions are based on fear, or on guilt or lack of information,” says Donna Coletti, MD. As medical director of Greenwich Hospital’s newly expanded Palliative Care Program, Dr. Coletti heads a team of caregivers trained to help patients and families make critical choices that affect quality of life at any stage of an illness. “It’s a whole person-whole family approach that addresses spiritual, physical and psychological pain,” she explains.

Who was this person before he got sick? Was he independent? If he knew the position he was in, would he want to be intubated? “In cases where patients can’t speak for themselves, these are the types of questions we ask their families,” says Dr. Coletti. “We don’t want to inflict pain on someone who, if they had their voice, would say, ‘this isn’t me.’”

Patients who can still communicate may not want more treatment, she notes, but will agree to it to please their children.

The palliative team, which includes physicians, a nurse, social worker and chaplain, helps patients and families understand the pros and cons of various treatments, including letting nature take its course. Outpatient consultations and counseling are available.

“Too often, we hear families or patients say, ‘if I only knew,’” Dr. Coletti says. She’s hoping to hear less of that as more people take advantage of palliative care and opportunities to plan ahead.

Palliative Care: The Right Choice for You?
It might be, if you are experiencing:
• Uncertainty about the prognosis and goals of care
• Difficult physical and emotional symptoms related to a serious medical illness
• Decline in physical health with multiple hospitalizations
• Prolonged hospitalization with poor prognosis
• Patient and family stress with unresolved emotional or spiritual issues
• Questions or concerns about a living will and advance directives

For more information on Palliative Care, call 203-863-4622.