Palliative Care Conversations

In the recent decade, public attention on the work of care for the terminally ill has greatly increased, largely through government funding of such work.  The American Board of Medical Specialties approved palliative medicine as a new medical specialty in 2006, followed by the first board certification granted for physicians in palliative medicine in 2008.  Clinical Chaplaincy has been an integral part of this emerging model of care.  In response, CPSP has developed a subspecialty certification for Board Certified Clinical Chaplains,  “Board Certified Clinical Fellow in Hospice and Palliative Care”   (FHPC). This will be a subspecialty credential for those first credentialed as Board Certified Clinical Chaplains (BCCC) or Board Certified Pastoral Counselors (BCPC). Procedure: CPSP Chapters  will receive requests from candidates for this certification, and will review the request.  The candidate for FHPC subspecialty certification may dow...

Sometime ago Don Berwick, MD spoke about 20 improvements that doctors could make in the end of life care of their patients that begins in a simple conversation. Berwick recommended the following considerations as his top three suggestions: 1.Ask yourself as you see patients, "Would I be surprised if this patient died in the next few months?" For those "sick enough to die," prioritize the patient's concerns - often symptom relief, family support, continuity, advance planning, or spirituality. 2.To eliminate anxiety and fear, chronically ill patients must understand what is likely to happen. When you see a patient who is "sick enough to die" - tell the patient, and start counseling and planning around that possibility. 3.To understand your patients, ask (1) "What do you hope for, as you live with this condition," (2) "What do you fear?," (3) It is usually hard to know when death is close. If you were to die soon, what would be left ...