Page 22 - SF HOSPITAL NEWS NOVEMBER 2020

HOSPICE & PALLIATIVE CARE IN SOUTH FLORIDA

Cover Story: “She Has Horrible Pain … Won’t Someone Please Help Us”

Continued from page 1 plexity. Dame Cicely Saunders, an English ventional procedures and treatments, chi- have thoughtful consideration for our opi-
physician and writer, had a legendary ropractic treatments, massage therapy, oid crisis while navigating the regulatory
brought to the nation’s attention an opiate
crisis affecting public health and influenc- career for pioneering the “modern” hos- acupuncture, and music and pet therapy. landscape, without compromising effec-
ing the countrywide conversation about pice movement and for her early emphasis More research for the use of medical mar- tive pain management. This can be accom-
pain management. Without a doubt, our on palliative care in clinical practice. She ijuana is anticipated for optimizing its role plished with sound strategies and practices
current opioid predicament has tremen- coined the term ‘‘total pain,” illuminating in pain and symptom management. that promote the safe use of opioids, pre-
dous effects on our collective welfare, both how complicated and multidimensional Opioids are not considered first-line treat- scribed by professionally competent prac-
social and economic. The National pain can be with having physical, psycho- ment for chronic pain outside of cancer, titioners. The awareness of palliative care
Institutes of Health (NIH) recently pub- logical, social, emotional, and spiritual palliative and end-of-life care, and for in helping to manage pain, as well as to
lished on their website that the total "eco- components that contribute to a “total symptoms associated with shortness of improve health, wellness, and satisfaction,
nomic burden" of prescription opioid mis- pain” experience that is as unique as the breath (terminal dyspnea) at end of life, is growing. Most large hospitals recognize
use alone in the United States is estimated people who face it. Palliative Medicine with there being exceptions under special the value and offer inpatient palliative care
at $78.5 billion a year; including costs of endeavors to maximize quality of life for circumstances. services. I have the privilege to provide
healthcare, lost productivity, addiction patients and families facing serious illness- Our legislature has enacted bills to safe- and supervise care as the Medical Director
treatment, and criminal justice involve- es. It supports curative treatment intended guard opiate use in Florida. Effective July for Catholic Palliative Care Services
ment. The website also states that more to prolong life, and it also provides choices 1, 2018, House Bill No. 21 increased the (CPCS). CPCS offers services in various
than 130 people in the United States die to life-sustaining treatment near the end of regulation, training, and reporting settings, including at home and in hospi-
after overdosing on opioids every day. The life, particularly when the value and bene- required for prescribing and dispensing tals. Since December 2018, CPCS provides
staggering statistical evidence, tragic sto- fits are questionable. controlled substances. It defined acute palliative care services at Holy Cross
ries, and untimely deaths illustrate how This is accomplished by exploring and pain with restrictions on certain prescrip- Hospital. We partner with physicians at
the issue deserves our full attention and defining the goals of care for each patient tions, required prescribers to consult the Holy Cross Hospital to support person-
purposeful efforts to responsibly protect and family, by supporting Advance Care prescription drug monitoring program centered care and to optimize health in
our communities and to deploy sound Planning, and by serving as a patient advo- (PDMP) before prescribing controlled sub- serious illness. The CPCS Team at Holy
mechanisms for opiate use, diversion and cate in shared decision making and med- stances with certain exceptions, among Cross Hospital includes a fulltime staff
addiction. Our recognition and efforts to ical management. Palliative care also other mandates. Effective July 1, 2019, comprised of a Board-Certified Palliative
end the opiate crisis however does not focuses on optimizing symptom relief by House Bill No. 451 (HB 451) established Care Physician, Advanced Registered
change the fact that pain exists, and it managing difficult symptoms such as pain, that competent adults have the right of Nurse Practitioner (ARNP), Social
requires conscientious and dutiful treat- as well as shortness of breath, constipa- self-determination regarding healthcare Worker, Chaplain, and Nurse Navigator.
ment. tion, nausea, loss of appetite, difficulty decisions, including the right to refuse Our Catholic Palliative Care Team will
Part of the reason I pursued becoming a sleeping, and depression, to name a few. treatment with a Schedule II opioid con- continue to adapt to the changing health-
physician was to satisfy my curiosity of the Palliative physicians recognize, like trolled substance. The bill also required care landscape, while advocating and
human body, a wonderous and unique sys- other clinicians, that nonopioid alterna- practitioners to provide an educational delivering effective pain management for
tem marvelous in design. How the body tives for pain are always considered first- pamphlet from the Department of Health people with pain, and for their families
responds and adapts to insult and to injury line treatment with examples including (DOH) to inform patients about available and caregivers. We hear you, and we are
fascinates me, and pain is a unique com- nonopioid medicinal products, physical nonopioid alternatives for the treatment of here to help.
and occupational therapy, selective inter- pain and to discuss nonopioid alternatives,
among other requirements. Dr. Tracy Romanello is Medical Director,
Pain control is a central component of Catholic Palliative Care Services and Catholic
symptom management, and its reliable Hospice. For additional information, contact
oversight is critically important to Catholic Palliative Care Services
patients, families, caregivers, and other at (305) 351-7086 or
healthcare providers. It is imperative to palliativecare@catholichospice.org.

CATHOLIC PALLIATIVE CARE SERVICES

Dr. Sanaz Kashan
Specializing in Medically Palliative Medicine Physician

Complex Patients Dr. Sanaz Kashan is the Founding Fellowship Program
Director of Hospice and Palliative Medicine at Aventura
Kindred Hospitals are owned by Kindred Hospital and Medical Center and also serves as the
Healthcare, Inc., a national network of Long Term Transitional Year Residency Program Director. Currently she is
Acute Care Hospitals (LTACH's). a Palliative Medicine Physician for Catholic Palliative Care
Services. Dr. Kashan is board certified in Internal Medicine,
Kindred Hospitals provide specialized, high quality Geriatrics Medicine, and Hospice and Palliative Medicine. She
care for acutely ill patients. For more than a decade, is an Assistant Professor at Florida International University
we have fine-tuned the art of medically complex care. Herbert Wertheim School of Medicine (HWCOM). Active in many medical organiza-
tions, Dr. Kashan serves on multiple committees within the American College of
Our services range from complex catastrophic Physicians, American Geriatrics Society and American Association of Hospice and
illnesses that require intensive care, post-surgical medical Palliative Medicine. Dr. Kashan’s career interests have been end-of-life care and advanced
rehabilitation to patients suffering from chronic diseases requiring respiratory and care planning, topics she has presented on at the local, state, national and international
rehabilitative therapies. Kindred Hospitals provide outcome-oriented level. Dr. Kashan is passionate about enhancing quality health care through medical edu-
cost effective care for patients with a wide spectrum of cation and inter-professional teamwork to improve health outcomes.
medical conditions.
Gisell Hernandez, ARNP
Admissions to Kindred Hospitals may be
recommended by physicians, acute-care hospitals, Nurse Practitioner
rehabilitation hospitals, managed care providers, case
management companies or by the patient’s family. Gisell Hernandez serves as an Advanced Practice Registered
In all cases family tours are encouraged. Nurse for Catholic Palliative Care Services at Mercy Hospital.
In 2017, Hernandez joined our Palliative team, initially pro-
viding services to patients and families in the community,
before playing an integral role in launching needed palliative
Kindred Hospital Kindred Hospital Kindred Hospital Kindred Hospital services at Mercy Hospital. She has dedicated the last two
Fort Lauderdale Hollywood Coral Gables The Palm Beaches decades to using her practical nursing skills to advance the
1516 East Las Olas Blvd. 1859 Van Buren St. 5190 Southwest Eighth St. 5555 West Blue Heron Blvd health and well-being of patients who receive her care.
Ft. Lauderdale FL 33301 Hollywood, FL 33020 Coral Gables, FL 33134 Riviera Beach, FL 33418 Hernandez’s experience spans administrative capacities, cardiology, skilled nursing care,
954-764-8900, ext. 5136 954-920-9000 305-448-1585 561-904-8451
intensive care, case management, and hospice services. Hernandez is goal directed and
www.khfortlauderdale.com www.khsfhollywood.com www.khcoralgables.com www.khthepalmbeaches.com
results driven which benefit her patients through her advocacy. When she is not working,
she enjoys spending time with her family.

22 November 2020 southfloridahospitalnews.com South Florida Hospital News