August 12, 2010

Palliative care post demands caring touch

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Karen Cassidy, M.D., M.P.H., talks with patient Alex Rodriguez. (photo by Mary Donaldson)

Palliative care post demands caring touch

Karen Cassidy, M.D., M.P.H., assistant professor of Pediatrics, has been named director of Palliative Medicine at the Monroe Carell Jr. Children's Hospital at Vanderbilt.

The position is a challenging one: working with families whose children have life-threatening or life-limiting illnesses. Cassidy often begins her work by helping families to overcome their negative perceptions of the term “palliative care” before she can begin the work of helping improve a child's quality of life.

“Families are usually very receptive once they learn more about the palliative care team,” Cassidy said. “My job is to make sure that their child has excellent symptom management. Families may choose aggressive therapy or comfort care only, but all children need to have their pain and other symptoms managed effectively.”

Eleven-year-old Alex Rodriguez was preparing to head for the Wizarding World of Harry Potter at Universal Studios’ Islands of Adventure Theme Park recently, but increases in nerve pain from cancer in his spine might have sidelined him from the fun.

During a visit to the Hematology/Oncology clinic at the Doctors Office Tower at Children's Hospital, Cassidy discussed medication adjustments with Alex and his mother, Lisa Leverette.

“Be sure to tell your mom if you need extra medicine, it may take a few days for the methadone to help you with your pain. You have to give it a chance to work,” Cassidy told Alex, reassuring Leverette that she will call to check on Alex the day before the family leaves on their trip so adjustments can be made if Alex's pain is not better controlled.

For parents like Leverette, it can be very difficult to make choices about the direction of care for their child. Cassidy says part of palliative care is to help families and patients sort through the information and make good choices about their care. When children are old enough to understand their illness, Cassidy recommends that they be fully informed and involved in decisions about treatment and care.

Cassidy works with many families and children who hope for a cure and who are receiving ongoing curative therapies. Some children, however, do not have a chance for cure and are known to have a terminal illness and limited time left with their families.

The palliative care team works with families and children facing terminal illness to make sure they are well supported emotionally and do not suffer at the end of their lives.

“This is a very positive time for palliative care at Children's Hospital,” said Debra Friedman, M.D., director of Pediatric Hematology-Oncology and medical director of the REACH for Survivorship Program.

“The development of an interdisciplinary model to provide services to children and families will provide immeasurable benefit. Dr. Cassidy brings a clarity of vision to this program that will both benefit patients and families and provide a strong base for developing community support.”

Cassidy, who received her Masters of Public Health from Harvard University in 1995, was on staff at Vanderbilt in Internal Medicine/Pediatrics from 2001 to 2006 before going to work for Alive Hospice. She says returning to practice palliative care at Children's Hospital is a natural progression for her.

“I feel very privileged to get to do this work. It is a unique way to make an impact on people's lives at a time when they need help from the medical system the most,” Cassidy said.