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Whole person care core of caregiving

May 30, 2018


When people are sick, we usually focus on their medical care, and ignore their “personal” care. There is a personal side to health care, which often gets overlooked. It doesn’t have to be this way. The solution is whole person care.


Whole person care is health care based on medical needs – and personal values, where patients are involved in decisions about their care, families receive help supporting loved ones who are ill, caregivers receive help coping with the strains of caregiving.


Whole person care is, at its core, a goal-aligned, relationship-based approach to caregiving. By encouraging clinicians to know their patients as whole persons, health care professionals can go beyond treating patients’ physical condition to also devote attention to patients’ emotional, social and spiritual well-being.


This approach benefits people of every age and stage of life. It is particularly valuable when people are living with serious medical conditions. Whole person care makes it natural for caregivers to understand each patient’s values, preferences and priorities. The result is highly personalised care.


At least 70 percent of Americans spend their last days in hospitals or nursing homes without the ability to communicate their final wishes. Recognising this, Providence St. Joseph Health (PSJH) – the nation's third-largest health system – is advancing changes in the way the end of life is treated in Renton, Washington and Irvine, California. The health system is introducing innovative tools and services that ensure patients' wishes are respected and families are wholly comforted.


"End of life is a topic both health systems and patients don't typically want to discuss," says Ira Byock, M.D., founder and chief medical officer of Providence St. Joseph Health's Institute for Human Caring, which is helping patients, families and caregivers experience the best care possible, especially during life-limiting illness. "In caring for the whole person and the entire life experience, we are normalising the conversation and taking on these initiatives to transform the way we care for those with serious illness through the end of life." 


"Every year, thousands spend their last days in hospitals and ICUs suffering needlessly, subjected to overly aggressive, inevitably futile and expensive treatments," Dr. Byock says. "We can and must do better."


To help make the final days less difficult and more comfortable for families, the institute is introducing several innovative tools, including a new advance directive online toolkit, available in multiple languages and tailored for each of the seven states where the health system operates. The free resource makes it simpler for people to make it known what type of care they'd want if they were unable to speak for themselves. The directives are stored and easily accessed in an electronic medical record system. It provides a full view of a patient's goals for care through new customisations of its electronic health record system. Goals-of-care conversations and advance directives are highly visible to the treating physician at each facility.  And, the system alerts doctors if ordered treatments go against a patient's requests.


Simple fact-based videos and other resources are prescribed for patients and families to help them understand their medical conditions and options for care near the end of life. Patients are actively engaged in shared decision-making to clarify achievable outcomes and goals for care prior to potentially burdensome treatments.


Physicians and staff are provided tools and extensive communication training to facilitate meaningful and compassionate conversations with patients and loved ones during one of life's most difficult times.


In working to change the conversation about end of life, the institute also captures inspiring patient and family stories as part of its 'Hear Me Now' series, a partnership with StoryCorps. Stories such as:




SOURCE Providence St. Joseph Health

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