Palliative Care Always breaks new ground in its approach to a medical specialty that has enormous potential to improve lives across the globe
BY SIMON FIRTH
Starting September 21, 2016, Palliative Care Always will be available once again through Stanford Online. First offered in Stanford’s 2016 Winter Quarter, the course is designed for a broad audience, including medical professionals, social workers, spiritual guardians, and patients themselves and their family members. It deploys a unique pedagogical approach, using a fictional narrative — the story of Sarah Foster, a fictional cancer patient — to illustrate the many facets of high quality care for those who are seriously ill.
“Palliative care is the practice of improving the quality of life for any patient with a serious illness,” noted course lead professor Dr. Kavitha Ramchandran, clinical assistant professor of oncology and Medical Director of Palliative Medicine at the Stanford Cancer Institute. “Disease affects patients — and their families — physically, socially, psychologically, and spiritually,” she explained. “Addressing these needs requires a team approach to care where each role has equal weight, which is the approach we are offering in the course.”
While it has been practiced in Europe for some time now, palliative care remains a relatively new specialty in the United States. Poorly resourced nations, meanwhile, have extremely few practitioners with palliative care training. “As a result we have a lot of global suffering and this course is one effort to answer the need for education and training to reduce suffering,” Ramchandran suggested.
Palliative Care Always follows the fictional Sarah as she moves from a cancer diagnosis through multiple stages of treatment to the end of her life and her family’s bereavement. Course participants see Sarah and her husband work with 11 different Stanford Health Care faculty and staff — including physicians, nurses, social workers, a psychiatrist, and a chaplain — to sustain her quality of life throughout her care.
“By following Sarah’s life story, we hear the points of view of the practitioner, the patient and the family,” explained Ramchandran. “We’ve also create a dialog between this intimate team of healthcare professionals and remember that the patient is at the heart of palliative care,” she said. “So it grounds us in why we do this every day.”
The course, which Ramchandran co-developed with a large team of faculty and staff, also features lectures presented by the Stanford specialists, opportunities for online reflection, and live video chats among the multidisciplinary, international participants.
Ramchandran created “Palliative Care Always” after her own research suggested that palliative care worked best when viewed as the concern of everyone who cares for a patient, rather than the sole responsibility of medical specialists who may not consult with others during treatment.
“What we’re trying to do is help everyone involved in caring for the patient better understand what other people are doing, or could be doing if brought into the care plan,” she says. “We want to be able to answer a whole series of questions that people interested in the field might have, such as: ‘How can palliative care help people? Who does it and how is it done? How do I advocate for it if I don’t have access to it? And can I find other people nearby with whom I can collaborate and learn more?’”
In its first run, the course met these goals and engaged over 1,400 participants, two thirds of whom were clinicians and more than 50% of whom were based outside the US. It also inspired ongoing study groups in a number of countries, including Singapore and India, where palliative care is sorely needed but remains significantly under-resourced.
This next version of “Palliative Care Always” features additional fictional vignettes that offer insight into the experience of family caregivers, as well as deeper dives into symptom management and communication.
“I’m really touched by is the global community we’re building,” she adds. “There’s an art of healing in all cultures, which — in many ways — we moved away from to focus on curing disease. This course is generating an opportunity for people all over the world to connect, build communities, and return our focus to changing people’s experience of their illness for the better. That can help them heal,” she said.