Valley View Hospital of Glenwood Springs is extending its in-house palliative services to outpatient care, the hospital recently announced.
“Palliative care and hospice care are two different things — palliative care is for people with serious illness that are pursuing life-prolonging therapy,” Shane Lieberman, M.D. said on Friday.
Lieberman and Brandy Drake M.D. have been doing palliative care for six years at Valley View. The Glenwood Springs hospital offers palliative care in-house and, most recently, outpatient care.
Palliative care now being offered as outpatient services is new and helpful. Sometimes it helps Drake and Lieberman catch problems earlier and helps them with the patient’s care.
This helps not only the physical care of the patient, but the emotional care of them and their loved ones. This process is for when the illness progresses, but sometimes the person is cured.
“People weren’t going anywhere for palliative care before this,” Lieberman said. “It wasn’t available. Primary care doctors try their best to do this, but they often just don’t have time.”
Palliative care can lead to hospice care, but Drake stressed they’re not about death.
“We’re not afraid to talk about death, but it can be a harm to associate palliative care with death,” Drake said. “We’re about life.”
Drake explained that hospice is limited toward the last six months of a patient’s life.
“I think it can confuse people, but hospice isn’t a place you go — it’s a philosophy,” Drake said. “Palliative care is the same, it’s not a unit.”
It’s all about quality of life, Lieberman said.
“We get involved early, we build a relationship with that person, and we focus on who the person is: what do they want? What’s important to them? This illness has changed their life, so who are they now?” he said.
Lieberman and Drake diligently work with oncologists and pulmonologists. They monitor specific areas in the body in which the cancer has invaded, while Lieberman and Drake look at the entire person.
Associating palliative care with death can mean that people seeking to pursue life won’t get it. However, Drake and Lieberman have their own facility next to the hospital that is a non-clinical space big enough for families. Palliative care is a discussion that involves loved ones and how life should be pursued by the patient.
“Palliative care is covered by Medicare, Medicaid, and most private insurances,” Lieberman said.
The hardest part of being in this kind of care is the emotional burden, both doctors said.
“Toughest part of the job is the emotional burden, to meet people where they are, who they are, what’s important to them, but that can be difficult because they’re very sick people and they might die soon,” Lieberman said.
Drake said another hard part of their training was the young people part of it.
“We don’t see a lot of kids, but even people in their 20s or 30s, who have a strange disease or just bad luck — it’s hard,” she said.
Lieberman also spoke about the Right to Die, known as Medical Aid in Dying or also known as Colorado’s End of Life Options Act. This Aid in Dying is in 10 states along with Washington D.C.
“One of the things we value is a patient’s autonomy, a person’s right to choose, especially around healthcare,” he said. “When going to the hospital, we can refuse a surgery, and for most of us, it may make sense to do it because we can get back to where we were, but as we get older it may not.”
This Act is viewed as hospice care and requires multiple qualifications — a terminal disease diagnosis, two medical professionals agreeing about the diagnosis and the patient being of sound mind while taking the medicine and able to do it themselves.
“I have written some of those prescriptions,” Lieberman said. “I always try to ask the patient if there’s a hope or another thing they can hold on to in these cases.”
“Sometimes the prescription is filled, but never used, or it’s written and never filled. Sometimes it’s for just in case. People like to feel they have some control over their own lives,” Lieberman added.
The palliative care team includes Drake, Lieberman, and Nurse Practitioner Erica Hickey and Board Certified Clinical Chaplain Lauren Martin. Palliative care appointments are by referral only, but anyone can get more information by calling the team at 970-384-4220.