1. An Introduction to Palliative Care for Health Care Interpreters Cynthia Roat, MPH Anne Kinderman, MD Alicia Fernandez, MD

2. Interpreting in Palliative Care Produced with support from the California HealthCare Foundation www.chcf.org February 2012Interpreting in Palliative Care2

3. What will you learn? At the end of this presentation, you’ll have a clear understanding of: – What palliative care is – How palliative care is provided – How palliative care relates to other types of care Hospice care Comfort care Pain management – Why interpreters are critical to providing palliative care February 2012Interpreting in Palliative Care3

4. Why do we need palliative care? February 2012Interpreting in Palliative Care4

5. February 2012Interpreting in Palliative Care5

6. Pallia – what? February 2012Interpreting in Palliative Care6

7. Palliate =to make less severe In health care, to palliate means to lessen the severity of the symptoms of an illness without curing or removing the underlying cause. February 2012Interpreting in Palliative Care7 From two Latin terms pallium: an outer garment or cloak palliare: to cloak

8. Remember this! Palliative care treats, prevents, or relieves the symptoms of a serious or progressive illness but does not cure it. February 2012Interpreting in Palliative Care8

9. Palliative care is for patients and their families and caregivers February 2012Interpreting in Palliative Care9

10. Palliative care also focuses on understanding a patient or family’s values, to help guide medical care “When you think about the future, what do you hope for?” “If you knew your time were short, are there certain things you’d want to be able to do, or see, or experience? Where would you want to be?” February 2012Interpreting in Palliative Care10

11. When can palliative care start? Curative care % focus 100 Time Death Terminal phase of illness bereavement Adapted from S Pantilat, PCLC 2005 Hospice Care Palliative Care Diagnosis of serious illness February 2012Interpreting in Palliative Care11

12. Palliative care + curative care Another important point to remember: Palliative care alone, when curative care is no longer helpful OR February 2012Interpreting in Palliative Care12

13. In a nutshell Palliative care February 2012Interpreting in Palliative Care13 aims to improve the quality of life for patients who are facing serious illness as well as for their family and friends. Can be provided at any time

14. How and where is palliative care provided? February 2012Interpreting in Palliative Care14

15. ..is a team effort! February 2012 Palliative care.. Interpreting in Palliative Care15

16. Palliative care provides: Time for family meetings and patient/family counseling Coordinating interdisciplinary meetings to discuss prognosis and treatment options Establishing goals of care February 2012Interpreting in Palliative Care16 Expertise in managing physical and emotional symptoms

17. Palliative care provides: February 2012Interpreting in Palliative Care17 Coordination of care across settings Patient admission, discharge Support in resolving conflicts Goals of care DNR orders and treatment requests

18. Palliative Care Teams may help patients and families complete Advance Directives February 2012Interpreting in Palliative Care18

19. Physicians may also help complete specific orders for future treatment(s) February 2012Interpreting in Palliative Care19

20. Palliative care Hospice care Pain management Comfort care February 2012Interpreting in Palliative Care20

21. What is hospice care? February 2012Interpreting in Palliative Care21

22. Hospice is for people with limited February 2012Interpreting in Palliative Care22 life-expectancy

23. Hospice... February 2012Interpreting in Palliative Care23

24. BOTH palliative care and hospice... February 2012Interpreting in Palliative Care24

25. Palliative Care February 2012Interpreting in Palliative Care25

26. But what about “comfort care”? February 2012Interpreting in Palliative Care26

27. What is the role of the interpreter in palliative care encounters? February 2012Interpreting in Palliative Care27

28. Remember Interpreters are asked to convey meaning, not just convert words. Are there messages communicated only by context, tone or word choice? Are there cultural issues? February 2012Interpreting in Palliative Care28

29. February 2012Interpreting in Palliative Care29

30. February 2012Interpreting in Palliative Care30

31. Palliative care emphasizes Maximizing quality of life Management of pain and symptoms Communication among the treating physicians Coordination of medical and supportive services Assistance with patient decision-making about care Support for caregivers Delivery by a team, including interpreters February 2012Interpreting in Palliative Care31

32. "You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but to live until you die.“ -Dame Cecily Saunders February 2012Interpreting in Palliative Care32

33. Thank you February 2012Interpreting in Palliative Care33