Calming the Covid 'beast' at Chestnut Hill Hospital with palliative care

by Stacia Friedman
Posted 11/18/20

As the pandemic spikes this holiday season, with Philly reporting the highest incidences of Covid in the state, the role of palliative care for Covid patients is in sharp focus. At Chestnut Hill …

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Calming the Covid 'beast' at Chestnut Hill Hospital with palliative care

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As the pandemic spikes this holiday season, with Philly reporting the highest incidences of Covid in the state, the role of palliative care for Covid patients is in sharp focus. At Chestnut Hill Hospital (CHH), palliative care is provided by KeystoneCare Home Care and Hospice of Wyndmoor. It's not just for patients in the hospital but for those at home in our community.

“There is a body of evidence now that demonstrates early palliative care involvement can actually help patients live better and longer,” said Huma Ansari, MD, KeystoneCare’s Medical Director of Palliative Care Services. “We help educate patients about their illness and guide them in making healthcare decisions to meet their goals, values and expectations to achieve the best quality of life possible.

“We prefer to see patients before they are critically ill and able to make their own decisions. We are much more effective in educating people about what to expect in the future and also in managing their symptoms when we are able to meet them early.”

In addition to pain management, palliative care may include psychological and spiritual counseling, nutritional guidance, physical therapy and coping mechanisms for caregivers. It also includes providing guidance with financial and transportation assistance. Palliative care is covered by Medicare, Medicaid and most insurance.

“For Covid patients, we can help in painting a picture of what life will be like during and after treatment for Covid. We help patients be more physically and emotionally comfortable despite being in isolation and away from their families,” said Dr. Ansari. “Our teams have been instrumental in connecting patients with their families through Telehealth, video conferencing and frequent updates to families who are worried and feeling helpless at home.”

To make hospitalized patients feel more at home, the palliative care team asks families to send them photos to post in the Covid patient’s room. They also share with the medical team information about the patient’s hobbies, favorite foods and music.

Another area where palliative care comes into play is in dealing with the side effects of Covid. “It is very important to us that our patients know what to expect going forward,” said Dr. Ansari. “We want them to have a realistic view of what is to come so they can prepare mentally and physically for the challenges. A serious illness can force a family to make major changes in their daily lives. Sometimes those changes are temporary, and some may even been permanent such as job loss, changes in physical ability.

“We are for all patients and definitely not just those who are at end of life. We take great care of people with serious illness who are receiving curative treatments and are expected to make a full recovery. Palliative care focuses on living well and understanding your health and treatment options. Patients can ask for us.”

Most readers of the Local are aware of Keystone Hospice, the historic property at Stenton Avenue and Birch Lane in Wyndmoor which offers care for terminally ill patients. Founded in 1994 by Gail Inderwies, Keystone Hospice expanded in 2009 to become KeystoneCare Homecare and Hospice, LLC. “I’ve seen a huge uptick recently in Covid cases with people who are asymptomatic,” said Inderwies, who now serves as KeystoneCare CEO and Executive Director.

“Covid is a beast. We’ve experienced it on our own staff, and we’re now trying to get ahead of the hurricane with new communal spread. Susan Higley Bray, MD and Chief of the Palliative Care Division, Department of Medicine, who has led the Palliative Care Program at CHH for over 10 years, and a Keystone nurse practitioner had their own Covid-19 experiences, recovering after contracting the virus this spring.

“The first five to 10 days are dicey. That's why it is important to monitor patients in their homes. Our Homecare services are for people dealing with breathing issues and activities of daily living. We put technology in their home to monitor vital signs and communicate by Facetime or Zoom,” said Inderwies.

KeystoneCare’s palliative team includes board-certified physicians, trained and certified nurse practitioners, nurses, social workers and counselors who are patient advocates. They also provide palliative care at Einstein Hospital Medical Center and Temple University Hospital. Their services include care in the home, delivered by a specialty-trained, interdisciplinary medical team to promote wellness in the face of chronic or advanced illness. Palliative care is covered by Medicare, Medicaid and most insurance.

How far is KeystoneCare willing to travel? “I will provide services anywhere,” said Inderwies, who recalls seeing a patient who lived in a van in a McDonald’s parking lot. “Wear a mask at all times,” she said, “This is not the time to be more lax.”

For more information, contact KeystoneCare at www.keystonecare.com or 215-836-2440.

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