When an ICS member has a serious condition that cannot be cured and the person is suffering in some way, palliative care allows us to focus on what matters most to the member. That’s why ICS is proud to announce a new partnership with the Center to Advance Palliative Care (CAPC), a program of Mt. Sinai Hospital. This relationship will help us increase our ability to provide excellent palliative services focused on our members’ individual wishes for their quality of life.
Through this partnership, all ICS staff can learn from CAPC’s expertise in palliative care, which fits perfectly with our member-centered approach. “Oftentimes in medicine we spend a lot of time treating issues instead of the whole person,” says Rachael Stacom, ICS Senior Vice President for Care Management. “At ICS and in palliative care, care managers are encouraged to look at the whole person and talk with the member about what they need and want at this point of their life.”
According to Rachael, depending on the member’s wishes, “palliative care may include dealing with chronic pain, helping the member gain mobility, or dealing with the depression that may come with an illness or chronic condition. The goal is to improve the quality of life for both the member and their caregiver.”
Palliative care is not hospice
While many people think that palliative care is synonymous with hospice care, it is actually an intervention that can be used at any time in a member’s life. Hospice, on the other hand, falls under the palliative care umbrella but has specific criteria, including a short life expectancy.
Our commitment to grow our palliative care capacity arose from a pilot program we ran at ICS to see what was needed for members who were at high risk for poor health. Early on, Rachael saw trends indicating that the negative effects of a member’s illness or condition could be reduced with a palliative care approach. She points out that, “Medical professionals are often devoted to fixing and curing illness, so for many of our members with disabilities or conditions that are not going away, this can pose a challenge to the way staff have been taught to do their jobs.
“We need to redefine how we practice and start by asking before we start doing – for example, by asking the member what they know about their disease before we start teaching them what they can do about it.
“It’s also important for us to ask how their disease or illness is affecting them, before we start recommending interventions based on our assumptions. When we ask, and listen to the member, it allows us to prioritize our interventions based on their priorities, rather than our own. This has been a hard but meaningful change for me,” Rachael added.
The problem with not asking, and just doing, is that it can result in applying a “fix it” mentality, something Jean Minkel, ICS Senior Vice President for Rehabilitation Services, discussed in her essay on patient autonomy last year.
In their quest to cure or improve a patient’s condition, clinicians often send people to a slew of specialists and medical appointments. If we start, instead, by listening to how a member’s disability or condition is affecting their life, discussing what we can offer, and then coming up with a plan, the member is more likely to feel validated, supported and – most important – to have their needs met.
A palliative care approach helps care managers to have difficult conversations, acknowledging the inability to prevent death, while supporting members to lead the way in getting the help they really want. At ICS, we don’t think there is a better illustration of what member-centered care actually means.