HPCI Fall/Winter 2020 Newsletter

LILIAN AND BENJAMIN HERTZBERG PALLIATIVE CARE INSTITUTE

PALLIATIVE CARE NEWSLETTER FALL/WINTER 2020

Brookdale Department of Geriatrics and Palliative Medicine Sweeps National Awards

For the first time in their history, the American Academy of Hospice and Palliative Medicine (AAHPM) granted three annual awards to one institution: the Brookdale Department of Geriatrics and Palliative Medicine.

Dr. Melissa Aldridge, Dr. Laura Gelfman, and the Center to Advance Palliative Care, directed by Dr. Diane Meier, were recognized for their transformational contributions to the field of palliative care.

Vice Chair for Research at the Brookdale Department, Dr. Melissa Aldridge received the 2021 Award for Excellence in Scientific Research. Dr. Aldridge’s exemplary research focuses on patterns of hospice use, transitions in care at the end of life, and the financial incentives inherent in the Medicare Hospice Benefit payment structure.

Dr. Laura Gelfman, Director of Quality and Information Systems for the Brookdale Department, received the 2021 Early Career Investigator Award.

This honor recognizes emerging research leaders for their promising contributions to the field’s scientific evidence base.

The Center to Advance Palliative Care (CAPC) is the recipient of the 2021 Presidential Citation, which is presented to organizations that have made significant contributions to the field. In their award letter, the Academy recognized CAPC’s work over the past two decades to grow high-quality palliative care programs and standardize best practices. They also cited CAPC’s work during the COVID-19 Pandemic to provide realtime resources, tool kits, and clinical training. Many of these resources were the products of front-line clinicians within the Hertzberg Institute.

CAPC and the National Palliative Care Research Center are the only organizations residing within a single academic department to receive the Presidential Citation.

Individually and collectively, these awards reflect the excellence in clinical care, education, and research produced by the Brookdale Department of Geriatrics and Palliative Medicine.

The awards will be distributed during the AAHPM’s virtual conference in February 2021. ■

BROOKDALE DEPARTMENT of GERIATRICS AND PALLIATIVE MEDICINE

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Hands-On Communications Training during a Pandemic This fall, the Hertzberg Institute launched its first virtual GeriTalk communications training course for Geriatrics and Palliative Medicine fellows. Expert communication is a cornerstone of palliative care, and GeriTalk’s two-day in-person course has been a key component of Hertzberg’s fellowship education for many years.

As with all the Institute’s educational offerings, the pandemic required a swift transition to virtual learning so that fellows could hone their skills and stay on track for graduation.

“If you had told me two years ago that GeriTalk could be successfully offered virtually, I would have had serious doubts. And yet, that is exactly what our incredible team of educators pulled off,” said Dr. R. Sean Morrison, Ellen and Howard C. Katz Chair, Brookdale Department of Geriatrics and Palliative Medicine.

GeriTalk is an innovative communication skills training program designed specifically for Geriatrics and Palliative Medicine clinicians. Built on the

foundation of experiential learning and deliberate practice, GeriTalk is an educational intervention which focuses on teaching, practicing, and reflecting on evidence-based skills. The course addresses basic communication skills, relaying bad news, and navigating goals of care in small group, one-on-one, and lecture style sessions. Through interactions with actors posing as patients or family-members, the learners develop their communication skills in an individualized step-wise fashion.

The first virtual course trained a total of 20 Geriatrics and Palliative Medicine fellows, including three learners from the University of Pennsylvania. “The feedback from our first virtual GeriTalk has been overwhelmingly positive and we are seeing fellows implement their skills in real time. I commend Associate Director of Education, Dr. Lindsay Dow, and Fellowship Directors, Dr. Helen Fernandez and Dr. Elizabeth Lindenberger, for pulling off what I previously thought would be the impossible,” said Dr. Morrison. ■

Researchers Team Up for National Dementia Study Researchers from the Hertzberg Palliative Care Institute will collaborate with the University of California, San Francisco for a national study of quality of life for persons with dementia and their families. The multi-million dollar, five-year study is supported by a prestigious grant from the National Institute of Aging. It will allow researchers to take the closest look yet at how serious medical illness, along with social and economic factors, affect people with dementia—from the time of diagnosis to end-of-life.

“We hope to better understand the types of care settings and interventions that impact the quality of life for people with dementia,” says Dr. Melissa Aldridge, Vice Chair for Research in the Brookdale Department of Geriatrics and Palliative Medicine, and co-lead investigator for the study. “We believe this is the first study to examine so closely the full trajectory of the illness and how options like end-of-life and hospice care may affect the patient’s experience.”

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Creative Arts Therapy Adapts to Healing from a Distance During the spring COVID-19 surge, the Hertzberg Institute designed new ways to deliver Creative Arts Therapy to patients and their family members, who were pressed with uncertainties, restrictive visitation policies, and isolation.

Art Therapists created an online creative arts platform and an emotional support and counseling service with extended and weekend hours. Much of this work centered on crisis counseling, creative adaptations for honoring personal legacies, and facilitating reflections about loved ones. Developmentally appropriate resources for coping were offered via Zoom for families and children. Therapists sought to help patients and families emotionally connect and process their experience and bridge the physical separation.

For example, family members experiencing shock and grief were able to express their emotions through poetry writing. The poetic form and collaborative writing process provided a structure for family members to release their emotions and honor their loved one, while having their words and experience witnessed, read back to them and recorded (if desired).

“When there is no more medicine and we are at a loss for words, art therapy offers a creative conduit for processing emotions that can yield a tangible record to honor relationships, reflect growth in difficult experiences, and engage with life at every stage of serious illness,” said Bridget Kuzma, Creative Arts Therapy Coordinator for the Hertzberg Institute.

High quality palliative care is offered by an interdisciplinary team of doctors, nurses, social workers, chaplains, and complementary therapies. The Hertzberg Palliative Care Institute has offered Arts Therapy among these services since 2011, to support patients and families with psychological coping and adjustment to illness, hospitalization, and loss through the therapeutic use of art making. The Creative Arts Therapy Program has been 100% donor funded since its inception. ■

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Provider Spotlight: GODSFAVOUR GUILLET, MS PHE, BSN, RN, NEA, BC Nurse Manager of the Wiener Family Palliative Care Unit Godsfavour Guillet joined the Wiener Family Palliative Care Unit (WFPCU) as Nurse Manager in March 2020, adding to her similar, concurrent role on the Women’s Health Unit. Her first task: to manage the WFPCU’s transition to a COVID-19 unit in response to New York’s spring surge.

Ms. Guillet led the nursing staff through a difficult year with expertise, dexterity, and compassion, providing the highest quality palliative care to hundreds of patients and their families.

Ms. Guillet says her first staff nursing position on a Geriatric Medical Unit helped her understand patients’ complex physical, psychological, and existential needs. “As a young nurse,

I recall having conversations with patients on how to advocate for their wellness and make decisions for their care. My sincere desire was that their worry and fear be mitigated,” said Ms. Guillet.

“I enjoy working on the WFPCU because it allows me to support the specialized care that patients need to be relieved of their suffering,” she said. “I truly believe that palliative care found me. As a child of Jamaican immigrants, I heard many accounts of suffering that instilled in me a need to provide comfort – in the form of direct nursing care to patients, education of nursing care providers, and support of nursing care providers.”

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PALLIATIVE CARE SAVES LIVES DURING COVID-19 PANDEMIC The Lilian and Benjamin Hertzberg Palliative Care Institute deployed multiple programs to alleviate the burden on the health system’s critical care teams during the Spring surge in COVID-19 cases. As the pandemic took a devastating toll on New York City, the Mount Sinai Health System cared for thousands of patients, putting front line clinicians under unprecedented strain.

Hertzberg’s programs saved thousands of lives by providing just-in-time support for these teams.

“Palliative care offers patients and their families an added layer of support during serious illness. During the COVID-19 Pandemic, we were able to extend that added layer of support to our colleagues throughout the city,” said Dr. Emily Chai, Vice Chair for Inpatient Services, Brookdale Department of Geriatrics and Palliative Medicine.

Palliative Care teams specialize in symptom management, establishing goals of care, and conducting family meetings. During the pandemic, these services were crucial. Common

symptoms of serious illness, such as shortness of breath and fatigue, overlap with common symptoms for COVID-19. Physicians in emergency rooms and critical care settings had limited time to establish goals of care with patients and their families, as they were pulled in multiple directions.

Further exacerbating the issue, patients’ families were not able to be at the bedside. Families were scattered, scared, and isolated.

The Hertzberg Institute deployed specialists to emergency and critical care settings throughout the Health System and launched a telephonic consultation line. These initiatives allowed palliative care to be anywhere and everywhere that it was needed. Palliative care specialists could consult the critical care physicians, take time with patients to establish goals, and virtually gather family members. With these services covered, critical care physicians were able to focus on the most urgent medical needs, saving countless lives along the way. ■

Lilian and Benjamin Hertzberg Palliative Care Institute Advisory Board Members Saskia Siderow, Co-Chair Susie West, Co-Chair Deborah Berg Jeannie Blaustein, PhD, DMin Beth Dannhauser

Peggy Danziger Joseph Hertzberg David Mitnick Lois Perelson-Gross Meryl Rosofsky, MD

Daniel Rube Stephen Siderow Jenny Steingart Zena Wiener

Lilian and Benjamin Hertzberg Palliative Care Institute Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place, Box 1070, New York, NY 10029 Tel. 212-241-1446 • www.MountSinai.org/care/palliative-care

Fourth-Century French Proverb

“To cure sometimes, to relieve often, to comfort always”

Fall/Winter 2020

PALLIATIVE CARE NEWSLETTER

Lilian and Benjamin Hertzberg Palliative Care Institute Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai One Gustave L. Levy Place, Box 1070 New York, NY 10029