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AZ Docs Get Innovative Training in End-Of-Life Care

May 17, 2010

PHOENIX, Ariz. - Medical schools teach students how to treat illness and injury, but typically spend little time on the specialized skills required for end-of-life care. Four years ago, Arizona's largest hospice agency, Hospice of the Valley, began training all Maricopa County internal medicine and family practice residents in "palliative care" - care that focuses on comfort, rather than cure, and usually comes into play when the patient can no longer be fully cured.

Dr. Gillian Hamilton, vice-president for education and innovation at Hospice of the Valley, says the program has been especially successful in teaching caregivers how to talk with patients approaching the end of life. A series of grants from the Virginia G. Piper Trust has allowed expansion of the training to include palliative medicine team members such as nurses, social workers, chaplains and hospitalists (who practice only in a hospital setting).

Hamilton says the training helps to overcome pre-conceived notions about palliative and end-of-life care.

"Here's one resident comment: 'I will be more aggressive about controlling end-of-life pain and not so hesitant about using higher doses of medications, if needed for adequate pain control.'"

The program teaches that hospice doesn't mean every patient is sickly and bed-ridden. Some hospice patients are still holding down jobs, Hamilton says.

"Saying that you might die in the next year doesn't mean 'I give up, there's nothing we can do.' It means 'Let's do everything we possibly can to have you live as joyfully as possible each day that you have.'"

Caregivers need to balance their desire to treat every condition a patient may have with what will improve that patient's quality of life and with what patients and their families actually want, Hamilton adds.

Doug Ramsey, Public News Service - AZ