Palliative Care

Palliative care is an approach to managing chronic disease and other serious and advanced illness that centers on relieving suffering and improving quality of life for patients and their families. Seven out of ten Americans who die each year die of a chronic disease. Our health care services need to evolve to provide appropriate care.

Palliative care customizes treatment to meet the needs of each individual, seeking to relieve pain, anxiety, shortness of breath, fatigue, nausea, loss of appetite, and other symptoms. Practitioners of palliative care help patients and their families understand treatment options, and facilitate effective communication among health care professionals, patients, and family members. Emotional and spiritual support for the patient and family are hallmarks of palliative care.

Palliative care differs from hospice in that it is appropriate at any point in a serious illness and can be provided at the same time as curative treatment. It may be offered in a variety of settings: hospitals, long-term care facilities, or people's homes. Aside from improving patient comfort and family satisfaction, studies have shown that hospital-based palliative care can have a positive economic impact.

To date, palliative care programs have developed primarily in large hospitals in urban settings. Models of palliative care for long-term care and for rural communities lag behind.

According to Minnesota's state demographer, by 2030, 21 percent of Minnesota's population will be over the age of 65, compared to 12 percent in 2000. This trend has enormous implications for health care services in rural areas, which already are burdened by fewer health care resources and a larger percent of elderly residents.

Minnesota Rural Palliative Care Initiative

Stratis Health is leading the Minnesota Rural Palliative Care Initiative, bringing together 10 rural communities to start or strengthen palliative care programs in their communities. Beginning in fall of 2008, Stratis Health is facilitating a learning collaborative, through which the community teams will design a model or focus for their community and will receive education to improve skills in palliative care. Over the course of 18 months, Stratis Health will host three learning sessions on palliative care, including care models in rural communities and core competencies for palliative care. Between the learning sessions, communities will work to achieve goals and will receive technical support. The work will culminate with an outcomes congress, where key learnings and accomplishments will be shared.

Managing a serious illness "takes a village." Palliative care brings together the support systems that patients-along with their doctors and with their families-need to determine how to plan for the best quality of life. For this reason, the community teams participating in the Minnesota Rural Palliative Care Initiative are made up of a variety of professionals from doctors and nurses to bereavement coordinators and clergy. Up to seven different organizations are participating on each of the teams, representing various combinations of care settings, including:

Assisted living

Clinics

Home health

Hospice

Hospitals

Nursing homes

Parishes and parish nurses

Public health agencies

Universities

The teams represent communities of varying sizes from across the state, variety in the type of organization where the palliative care program will be based, and diversity of organizations leading the teams. The 10 participating communities and their lead organizations are:

Bemidji - Bemidji State University Department of Nursing

New Ulm - New Ulm Home Care and Hospice

Olivia - Renville County Hospital & Clinics

Red Wing - Fairview Red Wing Health Services

Roseau - LifeCare Home Medical Center

Staples - Lakewood Health System

Waconia - Ridgeview Medical Center

Wadena - Tri-County Community Health Services

Willmar - Rice Memorial Hospital

Winona - Winona Area Hospice

Of the 10 communities participating in the Minnesota Rural Palliative Care Imitative, only Red Wing and Staples currently have a palliative care program in their community. Each team will develop and implement an action plan for developing and/or enhancing a palliative care program in their community. These programs will help patients better manage their symptoms, improve satisfaction with the family-clinician relationships, decrease problems with transitions between health care providers-such as when patients move from hospitals to nursing homes or from nursing homes to receiving care at home from a home health agency.

Thirty-five communities applied to participate in the initiative, indicating a strong interest and need to develop palliative care services to support rural communities. If successful, Stratis Health's rural palliative care project will be a model for implementing palliative care programs in rural areas throughout Minnesota and the country.

Introductory Presentation. This Web seminar provides an introduction to palliative care and the Minnesota Rural Palliative Care Initiative (recorded 7/17/08). The recorded conference call is available for playback. Download the accompanying handouts.

Stratis Health is leading the initiative, in partnership with Transitions and Life Choices, the palliative care program of Fairview Health Services. UCare has provided funding for the initiative. The Minnesota Department of Health - Office of Rural Health and Primary Care is providing a stipend to each community to help off-set travel costs.

If you have questions about the Minnesota Rural Palliative Care Initiative, contact Janelle Shearer, Stratis Health program manager, at 952-853-8553.