Hospice of Marin and MGH
Offer New Program

First Program of Its Kind in the Bay Area
Hospice of Marin and Marin General Hospital have teamed up to offer an innovative program to help patients with chronic pain or life threatening illnesses to manage symptoms and to live as pain free as possible.

Hospice Palliative Care Program Manager Sandra Wishon, RN, MS, said, “This is the first such collaborative program offered in the Bay Area by a free-standing hospice and an acute hospital.”

MGH Chief Nursing Officer Michelle Martinez, RN, said “This is a first for Marin General. We did not have a formal palliative care team that specializes in pain management with clinical experts in the field of palliative care.”

Palliative care is a multidisciplinary approach “that improves the quality of life for patients and their families facing life threatening illnesses through prevention, assessment and treatment of pain, and other physical, psycho-social and spiritual problems,” Martinez said.

“Palliative care affirms life and regards dying as a normal process,” she said. “It intends to neither hasten nor postpone death and integrates the psychological and spiritual aspects of patient care.”

The palliative care consultation team focuses primarily on managing the disease symptoms of any Marin General hospitalized patient who has a potentially life threatening illness, Wishon said, but may still be receiving active treatment for a disease.

Here is how the program works.

A Hospice team is called in -- either by a physician, nurse, the patient or the patient’s family – to assess the patient’s situation and consult with the patient’s physician regarding pain management and recommended medications. It also confers with the patient and his/her family, helping to make end of life decisions, if necessary.

All MGH patients that require palliative care can take advantage of this program, Martinez said.

MGH pulmonary disease specialist Dr. Alan Margolin, who also serves as medical director for Hospice’s San Francisco branch, said, “Most patients using Marin General’s palliative care services are still being treated for their illnesses. They may be receiving radiation therapy, but they are seeking symptom management and pain free days.

“Hospice patients, however, have reached a point in their lives where looking for a cure, or extending their life, is no longer the issue. These patients are seeking comfort, symptom management and a ‘good death.’

“Think of it as a continuum. A patient starts off with cancer and receives chemotherapy and radiation. He or she will most likely live for some period of time, but wants and needs symptom management, not unlike that provided for hospice patients. The patient wants someone to talk to in terms that are honest and supportive; someone who will provide emotional and spiritual support, and clarify goals and options.”

Hospice social worker Christa Williams, MSW, said, “Working hand in hand with the patient’s medical team, our team is available to see hospitalized patients of any age. We’ll talk with them and their families about strategies to manage pain and other symptoms.

“We’ll also address psychological, social and spiritual issues and work with the hospital’s discharge planners to assist with community resources.”
Wendy Wank, RN, NP, palliative care consultation team’s nurse practitioner, said, “The psychological and social services we provide are important because without addressing them a patient’s pain and other symptoms can become much worse.”

MGH Chaplain Bruce Murphy is also a member of the palliative care consultation team.

The program is funded by MGH and by designated grants and donations to Hospice.

Hospice President and CEO Mary Taverna said, “The palliative care consultative program is a beautiful example of two healthcare organizations working together to provide some of the best care and services humankind can offer. This is another way that Hospice and Marin General are responsive to community needs.”

Oct. 19, 2005