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Hospice and Palliative Care for All

Posted by Marjorie Charles-Damte, Lead Advance Practice Nurse

Hospice and Palliative Care for All

As an Advanced Practice Nurse and International Psychologist, I'm passionate about providing hospice and palliative care simply because it is the right thing to do.

Everyone facing serious illness deserves this holistic, compassionate care, and I feel extremely blessed to be part of an organization like JourneyCare – one that shares my vision of delivering care to all who need it.

Part of our shared mission is spreading the word about the need for this supportive care in our communities, in the United States and throughout the world. That is because, unfortunately, many people are not able to receive the hospice or palliative care they need. This includes not only patients in developing countries, but even citizens of our own country who are part of marginalized, stigmatized and vulnerable groups.

When I was introduced to palliative medicine, I was a clinician providing primary care in a public health setting, often to people with serious mental illness. The work was a challenge because my patients faced a complex mix of psychosocial, economic, medical and societal factors that often lead to a drastically shortened life-expectancy. My goal was to gain their trust and provide them care – care they were not accustomed to receiving, yet desperately needed.

One patient, whom I will call Brenda, lived with multiple psychiatric diagnoses that were best treated by therapy and medications. But she refused them, which is a common challenge among people with mental illness. When a case worker first introduced me to Brenda, she had just transitioned into a studio apartment after being homeless for several years. She was single and in her mid-30s, estranged from her family, had no children and had never worked.

It took about three months before she made eye contact with me, and several more before she would see me without her case worker. It took nearly two years before she allowed me to enter her home so I could complete an exam and collect blood work. This exam revealed abnormal findings, including several enlarged lymph nodes and a lump in her underarm. Soon my fears were confirmed: Brenda had breast cancer.

Although she agreed to see an oncologist, Brenda left the office abruptly after hearing her treatment options. She never returned.

I wish I could say Brenda received phenomenal palliative and hospice care, but she refused it and suffered greatly before she died.

I reflect on this memory as a reason to be grateful for all the ways I do get to make a difference in the lives of our patients – and to remind myself and my colleagues why we still have so much work to do in spreading education, awareness and availability of hospice and palliative care for all.


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