When Mohana Karlekar, M.D., talks with patient families, she almost always asks what they know about palliative care, and the answer is almost always the same — “Not much.”
But as the medical director of Vanderbilt University Medical Center’s adult Palliative Care Program, however, Karlekar says she has seen growing understanding and appreciation of these services within the Medical Center.
That increased awareness has culminated in the opening of the first designated, inpatient Palliative Care Unit at Vanderbilt. The opening of the new unit, located on the fifth floor of the Round Wing in Medical Center North, was celebrated Sept. 27, with the first patients moving into the unit on Sept. 28.
The Palliative Care Program’s mission is to ease the suffering and enhance the quality of care for patients and families dealing with an advanced or life-threatening illness.
“Five years ago less than 50 percent of hospitals had a Palliative Care Service. Now more than 50 percent do, but few have a unit like ours,” Karlekar said. “It shows tremendous buy-in. If you are going to take care of the sickest patients, this is part of the service we need to provide. At the end of the day, this unit is Vanderbilt saying this is an important thing.”
The nine-bed unit has been recently renovated and is staffed with registered nurses and others trained in palliative care. In addition to Karlekar, five physicians, a social worker, three advanced practice nurses, two case managers and a chaplain work to serve patients in the new unit as well as the active, hospital-wide consultation service.
Karlekar says a common misconception is that palliative care is equivalent to hospice, or end-of-life care, but in hospice, there is no curative care offered.
The wife of one of Karlekar’s recent patients said when she heard a palliative care expert would be coming to speak with her, she had to look it up on the Internet to see how it differed from hospice. In palliative care, curative care can continue, while also focusing on symptom management and developing a reasonable and realistic plan based on the patient’s medical condition and their wishes.
“Given the acuity of patients who are admitted to our institution these days, really all of our patients could benefit from this service,” Karlekar said. “This unit gives us the chance to really get to know people, understand their values and what makes them tick. We can ask how they like to spend their time, how did couples meet. Then we are better able to guide them through difficult decisions and come up with a plan of care that is right for them. That is one reason many of us have been drawn to this area.”
From the Palliative Care Unit, patients may go home or transfer to a rehabilitation facility or to hospice, based on the patient’s needs and wishes.
