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Palliative Care: Living With a Serious Illness

This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Welcome to the podcast. I'm Deborah Howell. And today, we'll be talking about palliative care, who can benefit from it and what it looks like in practice. Our guest is Dr. Marshall Gillette, Medical Director of Palliative Care for the Palliative Care Program at MemorialCare Long Beach Medical Center. Welcome, Dr. Gillette.

Dr Marshall Gillette: Thank you for having me.

Deborah Howell (Host): Really appreciate you taking some time out of your day to be with us. So, what is palliative care?

Dr Marshall Gillette: That's a great question. The way I think about palliative care is just like cardiology or dermatology. It's a specialty service that's dedicated to helping people with their best life and when they're dealing with a challenging or serious illness or health condition. It's usually provided by a team that includes multiple disciplines. Our palliative care teams here at Long Beach Memorial include doctors, nurses, social workers, and chaplains. And we all work together to ensure that we're caring for all aspects of a person rather than just their illness.

Deborah Howell (Host): Sure. Always great to have a team. And how can palliative care help people living with a serious illness live better?

Dr Marshall Gillette: There's a lot of ways that we help people live better. One thing that we often focus on is helping people feel their best. So recently, we had a woman come into our office, who was sent by her oncologist. She was undergoing treatment for uterine cancer and it had been causing some pretty severe nerve pain in her legs. She was in so much pain that, when I first met her, she could barely walk. She couldn't do the things that she really loved doing, like gardening in her yard, play with her grandchildren. So, we were able to take the time to not only understand what was going on with her health, but also how it was affecting her and her life. And we were able to treat her pain in addition to some other things that we did with her. And the really wonderful thing was by about her fourth visit, she walked into our office with a smile on her face and was able to tell us, you know, a really wonderful story about a hike she had gone on with her family.

Deborah Howell (Host): That's just such wonderful, wonderful progress. And I know you can't do that for everyone, everyone's different. But boy, those successes have got to mean something, right?

Dr Marshall Gillette: Yeah. How we can help people varies as much as each individual person. But I feel like the way that we help people all really starts with that same kind of patient-centered focus and care on their quality.

Deborah Howell (Host): Now, what kinds of illnesses can palliative care help with?

Dr Marshall Gillette: Our view is that really anyone with a serious illness or serious medical condition can benefit from palliative care support. And we take care of people dealing with heart or lung conditions, people undergoing treatment for cancer, people living with cognitive or memory issues like dementia. Really any health issue that is serious or life-changing, palliative care can help with.

Deborah Howell (Host): Now, people think about palliative care and they go, "Hmm, how?" And then they go, "Where?" So, where are the different places someone could receive palliative care?

Dr Marshall Gillette: The short answer, particularly here at MemorialCare, is they can get palliative care anywhere. We have a palliative care team that supports people who are in the hospital. We have a palliative care clinic where people can come and see us in the office and, now, between our home-based palliative care team and virtual or video office visits that we offer, and we can even support people who are in their home. So, the really nice thing about where we are in palliative care currently is that wherever you are, that's where we can meet you.

Deborah Howell (Host): So, it could be as simple as going in for treatment one day and then having a video chat with your chaplain the next day.

Dr Marshall Gillette: Yeah, absolutely. Or if you're fortunate enough to have a palliative care team that works in the same office as one of your doctors, you can come in and see your oncologist. And right after that visit, check in with your palliative care team and kind of do some one-stop shopping.

Deborah Howell (Host): That's beautiful. And how is palliative care integrated into someone's treatment plan?

Dr Marshall Gillette: I think integrated is a really nice word for how it works. Our palliative care team works right alongside with all of your other doctors, just like any other specialty would. So, I mentioned earlier, palliative care team works just like a pulmonologist or any other doctor on your team. And so, we coordinate with the other people helping take care of you. Make sure that we're working together, and are supplementing or supporting your care in whatever way we can.

Deborah Howell (Host): Now, I know you see this every day. Can you tell us some of the benefits of palliative care?

Dr Marshall Gillette: It's a broad answer, which is a good thing in how much we can help people. But I think of it often as sort of three main areas, where we can help people the most. One, which we touched on an earlier question, is really helping someone feel as physically good as they can. And so, sometimes that's by helping them manage pain. Sometimes that's helping resolve nausea, improving tiredness or fatigue, or really anything else that is limiting someone. That piece is often done through the doctor or the provider on the team.

The second area is really helping someone feel as mentally and emotionally good as they can. We know and we see that living with the stress of a serious illness and all of the extra stuff that comes with that, extra doctor's appointments, evaluations, treatments, it can be exhausting, it can be overwhelming. And so, we want to make sure that we're focusing on the whole person when they see us and helping them both navigate the medical challenges they're dealing with, but also just the challenges of dealing with all of those medical challenges. And that support is often done by the social worker on the team and the chaplain on the team.

And then the third thing that we help with or do for people is that, once we've made sure that someone is feeling as good as they can, we like to help figure out what their of healthcare priorities are, figure out what they're looking for from their healthcare teams, from their care plan, so that we can help them and their other doctors match up the care they're getting with what they want as best we can. And that's really done by the whole palliative care team together.

Deborah Howell (Host): You know, at what point should a patient talk with their doctor to see if palliative care is right for them?

Dr Marshall Gillette: I like to think that the right time to get palliative care support is as soon as you're dealing with a serious illness or health condition. Really anytime someone feels like the challenges or the burdens of a serious illness, whether those are physical, emotional, or spiritual are coming up and causing any kind of concerns or issues for them, then that is the time to ask your doctor if palliative care could be right for you.

Deborah Howell (Host): And I'm wondering about the whole community aspect of this. Are there support groups for people in palliative care?

Dr Marshall Gillette: So, there aren't palliative care-specific support groups. But one of the things that we absolutely help people with is assessing what the challenges they're dealing with are and plugging them into community resources. So whether those are things like support groups for them or their family or their caregivers, counselors in the area, programs that can help them with their health conditions, any of those things that can provide extra resources or support to make their lives better or easier are things that we'll work with them to get plugged into.

Deborah Howell (Host): Sure. It really does sound like you're caring for the whole patient, the whole person, and that is a wonderful thing indeed. Where can people go to learn more about palliative care?

Dr Marshall Gillette: The easiest place to go is to our website. It's got some great information and resources on how to connect with palliative care and what palliative care is, and that's

Deborah Howell (Host): Okay. Is there anything else you'd like to add to our conversation today, Dr. Gillette?

Dr Marshall Gillette: Really just that if you're ever unsure if palliative care could be helpful or not, then I just recommend asking your doctor and having a conversation. And I think they can really help you figure out is this a good service, how do you get in touch with a palliative care team in your area, so that we can make sure we're really supporting everyone that we can as best we can.

Deborah Howell (Host): That's great advice. Thank you so much, Dr. Gillette, for your time and your expertise today. We really enjoyed having you with us.

Dr Marshall Gillette: Absolutely. Thank you for having me.

Deborah Howell (Host): And for more information or to listen to a podcast of this show, please visit That's That's all for this time. I'm Deborah Howell. Have yourself a terrific day.

Palliative Care helps provide patients with relief from symptoms and the stress of a serious illness, but many patients fail to receive the care they need due to not knowing or understanding the benefits of palliative care. Dr. Gillette will share what palliative care is, who can benefit from it, and what it looks like in practice.