Northern Light Palliative Care helps patients live their best lives

People who have received a chronic, life-altering or life-limiting diagnosis can live their best life with the help of Northern Light Palliative Care, and there have been recent changes in the delivery of palliative care.  The Northern Light Health system includes Northern Light Mayo Hospital in Dover-Foxcroft and Northern Light CA Dean Hospital in Greenville.

Palliative care helps patients and their families navigate the challenges of a serious illness and assists in accessing medical care while adapting to a new way of life. Palliative care services can be offered in different ways such as in an outpatient clinic setting, telehealth services, and remote patient monitoring.

Northern Light Health Palliative Care Service Line Medical Director Dr. Vanessa Little, DO, FAAHPM said there have been recent changes in palliative care delivery. “We’ve had nurse practitioners who visited people in the home exclusively and now we’re moving to expand the program to a clinic setting and the in-home model is going to be changing a bit,” Dr. Little said.

Patients can still receive home care “but we’re trying to have palliative care be available to more people,” she said. “We are going to be relying on technology to get the providers, nurse practitioners, and physicians in homes via technology and then have people in person through Northern Light Homecare & Hospice with nursing, critical therapy, and occupational therapy just as we always have.”

Palliative care differs from hospice care, which is for end of life. Palliative care helps people feel better by addressing side effects of disease and treatment. The improvements in quality of life enhance well-being while reducing stress.

Northern Light Palliative Care provides information about disease management, symptom relief, and spiritual care. Working with other healthcare providers helps ensure people receive the right care for their specific needs and live their best life through pain and symptom relief as well as psychological and spiritual care. Palliative care provides relief from nausea, pain, loss of appetite, sleeping problems, breathing difficulties, and other symptoms.

Palliative care teams help manage symptoms and support people living with serious illness, families, and caregivers every step of the way. They focus on advance care planning and adjusting to new life situations based on each person’s needs. The team helps people move or stay in their home, a long-term care facility, hospice, or healthcare setting, and can assist with transitions and hospitalizations.

Patients may not fully understand what palliative care is, Dr. Little said. “What I say is we are a specialty service and medicine that recognizes that the serious illness impacts every area of your life,” she said. “We are here to figure out how it is impacting you and what is most important to you so we can help you live your best life even with this illness.”

The concept can still seem vague. “So I can help make recommendations and guide people toward resources that will help fulfill their goals because some people might want to leave the hospital, some people might want to do every possible diagnostic test or treatment, some people might want to get extra opinions in another state,” Dr. Little said. “We will hear what those wishes and goals are and then structure the care around that.”

Palliative care is provided by an interdisciplinary team, such as doctors, nurses, social workers, volunteers, and spiritual care providers, to find the best care for the patient. Team members do not have to specialize in palliative care to be providing it.

Research shows patients’ care is equal in terms of quality measures and effectiveness whether they receive palliative care in person or virtually. She said this is from the convenience for patients and families to not have to come into a clinic, “especially when they are living with a serious illness and have tons of other appointments.”

“Teleheath allows us to access people who otherwise might not have access to palliative care,” Dr. Little added.

Northern Light Homecare & Hospice can provide remote patient monitoring equipment to get vitals, such as heart rate, blood pressure, and oxygen levels in real time. “That’s another way that we can reach people and keep them home,” Dr. Little said. “I think we finally have tools to try to make that happen more often.”

Family members from out of state can be involved through telehealth palliative care, people who in the past may have not been part of the conversation.

“There certainly are some drawbacks, I can’t give someone a hug, I can’t give them a Kleenex, I can’t push silent on an IV pole when it is beeping,” Dr. Little said about remote services. But for some patients being at home allows them to be in a comfortable place and have some control “and I think for some people that is a positive,” she said.

Others would like to be home but would prefer to have care providers stop by.

“We want to grow and we want to meet the needs of Mainers,” Dr. Little said, with Northern Light Palliative Care working to find the best care for patients.

“A big part of our job in palliative care is making sure everybody knows the most up to date information about that patient,” she said. 

Palliative care is for anyone living with a serious illness that wants the extra levels of support.

“Sometimes it might be one visit to talk about goals of care, to complete advanced directives, talk about what kind of care somebody might want in certain circumstances,” Dr. Little said. She said someone might need care for months and even years and palliative care would be involved the entire time.

“For anyone who is living with serious illness, we commonly think of cancer but that can also be heart failure, lung disease, dementia, people who have suffered from a stroke in the past, or really any other serious illness that is affecting their quality of life where they can’t do the things that they used to be able to do,” Dr. Little said. “Maybe you are having symptoms that are impacting quality of life or they may have decisions to make about what kind of care they want, what kind of treatment they want. We can help with those things.”

Palliative care does not take the place of other medical providers, but is an added layer of support.

This support can help devise a care plan, such in an emergency as some patients would prefer to stay in their local hospital while others want the highest possible level of care.

“When you show up in the emergency room, their instinct is to act,” Dr. Little said about ER staff. “If what you want isn’t the default, which is the most aggressive life-prolonging always, you need to communicate that in writing and also to everyone that cares about you and is going to make decisions on your behalf.”

“Mainers want to be independent and we want to decide for ourselves most of the time and and we try to make sure people have that opportunity,” she said. “You don’t have to give anything up, it’s just an added layer of support.”

Dr. Little said those interested in being seen by a palliative care provider should talk to their primary care doctor or a specialist and ask to be put in for a referral. Most insurance plans, including Medicare and Medicaid, cover palliative care.

For more information, please call 207-400-8741 or go to https://northernlighthealth.org/Services/Palliative-Care#providers.