Supportive & Palliative Care – Improving Quality of Life for Patients & Families

Supportive & Palliative Care – Improving Quality of Life for Patients & Families

What is palliative care?
Palliative care is specialized medicine for people living with serious or chronic illnesses. It’s appropriate at any age or any stage of an illness and it can be provided along with curative treatment. Palliative care really focuses on providing relief from the symptoms and stress of an illness, with the goal of promoting quality of life for patients and their families.

Content derived from a DocTalk with Valley’s supportive and palliative care team.

What patient populations does your team see and how do you support those patients?
We see a wide range of patients including people diagnosed with cancer, heart disease, liver disease, kidney disease, dementia and much more. Our goal is to support patients by helping them improve their quality of life, identifying their goals, aligning treatments to those goals, and helping relieve symptoms of their illnesses. We support people as they transition from one phase of life to the next, providing them with education about their illness and its expected trajectory. We also work to support patients by closely communicating with other members of their care team, making sure that everyone knows the patient’s goals and desired treatments and we’re all on the same page. We try to involve the patients’ loved ones or family members along this path as well.

As an example, we saw a young woman in her 50s in the hospital who had end stage heart failure, with many hospital readmissions due to symptoms related to her heart failure. She didn’t realize how limited her life expectancy actually was, and after we met with her, listened to her story, I helped her identify some goals. We were also able to explain the severity of her illness and expected course with her current lifestyle. She reflected upon our discussion and ended up making some major changes to her health and has been following up with her cardiologist team, taking her medications, and is now working toward becoming a transplant candidate.

What different services does your team provide?
We like to think of our different services in five domains:

  1. Education: We can help patients better understand their diagnosis, its expected trajectory, and their treatment options and goals. By exploring what’s important to the patient, our team helps to match their goals to the available treatment options.

  2. Care Coordination: Navigating life and healthcare with a serious chronic or non-curable illness can be tough, so we help communicate with other doctors and specialists, so the entire care team knows and understands what’s important to a patient, and that the treatments match the patients’ goals.

  3. Symptom Management: We help to address the symptoms that can arise from illnesses or the treatments for those illnesses.

  4. Support: We offer a listening ear and can help support patients and their loved ones with their ability to cope with their illness and its impact on their day-to-day life.

  5. Advanced Care Planning: This is often part of the conversation we have with patients about their goals and wishes. We may talk to patients about a durable power of attorney, to appoint someone to help make healthcare decisions for you if you’re not able to, or a healthcare directive that outlines a patient’s medical wishes.

When should patients ask for palliative care?
Palliative care is appropriate at any age and any stage of an illness. It is recommended that palliative care is involved early in your illness so that you can get the support and services that you need from the beginning of your treatment.

How can patients and family members advocate for themselves if they have a serious or terminal medical condition?
You can always ask for palliative care to be a part of your care team. If you are here in the hospital, you can ask your main medical provider to get our team involved. If you’re an outpatient at Valley, and you have a cancer diagnosis, you can ask your oncologist to place a referral to our team. If you want to see palliative care, but do not have a cancer diagnosis, you can go to for additional resources, or you can also reach out to your primary care provider for more resources about palliative care in the community.

Who can receive care from a chaplain?
Any patient admitted at Valley can ask for a chaplain visit through their nurse or doctor, as well as through the GetWell network. The spiritual care team is skilled in providing a warm and compassionate presence to everyone in our spiritually diverse community.

Meet the team!

Pauline Lao, DNP, ARNP, ACHPN

I’m a nurse practitioner on the palliative care team and I currently work with patients in the supportive and palliative care clinic, which is rooted in oncology. I started my career as a registered nurse on a medical surgical unit and it was my experience working with patients and families at the bedside that really inspired me to pursue a career in palliative care. I feel it is an honor to be able to walk alongside and support people during some of the most vulnerable times in their lives. I completed my Doctor of Nursing practice degree at the University of Washington and went on to complete a year-long fellowship in geriatrics and palliative care before joining Valley in 2018.

Click here to learn more about Pauline Lao, ARNP

Amisha Mehta, MD

I’m one of the physicians on the palliative care team and I work primarily inpatient, seeing patients when they’re admitted to the hospital. My background is in internal medicine, and I did extra training, or fellowships, in geriatric medicine and palliative medicine. Prior to joining Valley in 2020, I worked in the outpatient setting taking care of older patients with chronic, complex, and psychosocial medical issues.

Click here to learn more about Dr. Mehta

Elaine Liu, MD

I did medical school and a family medicine residency in Singapore and have always been interested in holistic care and whole person care. I am board certified in internal medicine, geriatric medicine, and palliative medicine and have worked with older adults in a county hospital in Chicago. I have always been interested in trying to meet people where they’re at and ensure that the whole person is taken care of.

Click here to learn more about Dr. Liu

Josie Evangelista, ARNP

I am the nurse practitioner in the inpatient palliative service. My nursing career started as an ICU nurse and then I went back to school to become a nurse practitioner. I did a lot of chronic disease management, seeing elderly patients and doing a lot of advanced care planning that led me to the palliative care team. I’ve been working for about eight years as a palliative care clinician and I enjoy it very much.

Click here to learn more about Josie Evangelista, ARNP

Susanna Kron, MSW, LICSW, APHSW-C

I got my master’s in social work at the University of Washington and then worked as a medical social worker at Harborview Medical Center.  I primarily worked in one of the ICUs there and this is where I really learned about palliative care.  Through this work, I also learned that I found a lot of meaning in really getting to know each patient as a whole person, what is important to them, what quality of life means to them, and then how this translates to helping provide them with the best care possible.  I was excited to move into the specialty palliative care role on the inpatient palliative care team here and have worked here for three years.

Nisar Stephen, Spiritual Care Provider

As a spiritual care provider, I value the whole person. The palliative care team values spirituality through care of all patients and their loved ones. I’m available to our patients, their families, and to our staff for their spiritual care and support.

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