Innovative Palliative-Care Model Reaches Hospital Patients
The 70 hospice volunteers were learning Tibetan Buddhist breathing techniques among many facts and approaches that can't be easily learned from the standard PowerPoint lecture. The volunteers in the "Being With Dying" workshop were much like thousands of others taught by G. Jay Westbrook, except that they were inmates at one of California's largest prisons.
These inmates and others at another facility where Westbrook has taught in partnership with the California State Prison Hospice volunteer in the prison hospice and learn techniques to help them better serve dying prisoners with whom they sit vigil. But whether Westbrook is working with incarcerated volunteers or with health professionals or volunteers at programs located from the Harvard Medical School's Department of Palliative Care, to the Los Angeles Breast Cancer Alliance, his Palliative Care and Bereavement Program aims to offer emotional support to cancer patients.
Westbrook developed the program, which won a 2006 American Society on Aging Healthcare and Aging Award, in his role as clinical director of Valley Presbyterian Hospital (VPH), a 38o-bed nonprofit community facility in Van Nuys, Calif. "Historically," Westbrook explained, "the dying process has not been well managed in hospital settings. Neither patients nor their families received modi support for their grief-related emotional and spiritual suffering. Furthermore, physical pain was often undertreated, particularly in elders."
In recent years, many teaching hospitals have led the way in developing inpatient palliative-care programs, Westbrook said. However, these efforts have predominantly involved a special unit or wing of the hospital that is remodeled and staffed to accommodate dying patients. Although that model is convenient and roomy enough for teaching rounds or rotations for interns and residents, he continued, "many, if not most, small community hospitals interested in palliative care find this model untenable because of high costs and overwhelming staffing requirements."
Westbrook, who was named the 2005 Nurse of die Year when he was presented the Nursing Excellence Award from NurseWeek Magazine, developed a scattered-bed model that is adaptable to any hospital setting or type of unit. Especially for smaller hospitals, he said, the scattered-bed approach obviates the need to remodel and furnish a wing or floor, and it avoids the cost of having to recruit, hire, train and pay new people to staff the unit 24 hours a day.
For patients, he noted, the WH model avoids the stigma of being sent to an area that is known to care only for terminally ill patients. In addition, it saves physicians time, by allowing them to visit their patients in a regular clustered area, such as the oncology unit, rather than having to add a visit to a special palliative-care ward to their schedules. …