Monday, January 2, 2017

Palliative Care Patient Intimacy (Research, Cancer Video 1:37)

Palliative care is a medical approach for people facing problems associated with life-threatening illnesses. Focused on improving lives of patients and their families, this care prevents and relieves suffering from symptoms and stress of medical conditions. While palliative care and hospice care both provide comfort, palliative care can begin at diagnosis and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when the patient has been medically predicted to have up to six months to live, although some do live longer.

Intimacy, which is often impacted by serious illnesses, should be an important part of a palliative care assessment. Unfortunately, intimacy concerns are rarely assessed for hospital patients receiving palliative care. Why is that? Is it because most patients don’t want to discuss intimacy about their lives? Or is it because most healthcare providers rarely ask about it?

Research on palliative care intimacy was done that provides evidence of the correct answer. Performed at two hospitals, patient screenings included two questions to help identify intimacy issues and palliative care team communication to the referring medical team. These were the results:

1) The vast majority (96%) of patients reported that they had not been asked about intimacy concerns before the palliative care consultation.
2)  A slight majority (56.2%) reported that illness had either significantly or moderately impacted intimacy.
3)  Most (96%) found the intimacy discussion helpful and wanted to discuss these issues with medical providers.
4)  A majority (70.5%) of patients at the end of life indicated their illness significantly or moderately impacted their intimacy.

The need for intimacy discussions between palliative care patients and healthcare providers is important, and patients do want to have them. These discussions should be included as a regular part of routine assessment. 

The Sexuality, Intimacy, and Menopause clinic (SIMS) is one of the first programs in the country to focus on rebuilding the lives of women after they have survived cancer. Many cancer survivors have issues with sexuality. The clinic was started by gynecological oncologist Dr. Elena Ratner and Dr. Mary Jane Minkin, a specialist in menopause, in cooperation with Dr. Dwain Fehon, the chief of psychiatric services at Yale-New Haven Hospital. 

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

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