Community paramedicine supports palliative care by providing pain management, healthcare coordination, environmental assistance, and help with a person’s social and mental needs. Community paramedicine can accomplish this by acting as the central network through which individuals in palliative care connect with all aspects of their treatment.
The Role of Community Paramedicine in Supporting Palliative Care at Home
Palliative care does not necessarily mean end-of-life care; instead, palliative care encompasses more than just the physical needs of the patient – it refers to providing comfort in all aspects, including physical, psychological, emotional, and even spiritual.
In the following sections, we’ll discuss how community paramedics can work within a broader healthcare system to support the efforts of palliative care teams. As you’ll see, one of the biggest challenges with palliative care patients (and the sole purpose of this article) is communicating clearly with other members of healthcare.
Too often, healthcare providers make assumptions about what should or should not be done for someone receiving palliative care. Unfortunately, when this happens, it creates an even greater burden on the patient.
Here’s how community paramedicine and mobile integrated healthcare support palliative care:
- Focusing on the Management of Pain
- Providing Resources for Mental Health Care at Home
- Ensuring that Social Needs are Met
- Providing Clear Communication and Reassurance During the Treatment Process
- Helping People Navigate a Complex Healthcare System
Let’s discuss each of these points in detail.
Community Paramedicine Can Assist Palliative Care at Home by Focusing on Pain Management.
Palliative care might be summed up this way: making people comfortable. In this regard, community paramedics can assist in various ways, one of which is pain management. Often, community paramedics are trained in the administration of strong pain medications, which can be used strategically to make people more comfortable.
A few ways community paramedics make a difference (as opposed to just prescribing medication for patients to take on their own time) are that they can assess patients’ needs and then deliver a specific medication that is best suited for them at that time.
For example, some people might be prescribed Morphine for pain. For many people, this works well; however, for others, Morphine has a lot of side effects that can be unpleasant (these include things like constipation and nausea). In this case, the community paramedic might opt to administer a different medication, particularly if the patient has already been experiencing nausea.
Additionally, the community paramedic may be able to prescribe a medication that reduces the side effects of the pain medication. Finally, the community paramedic is specially trained to look out for severe side effects that could be life-threatening, such as a patient losing their drive to breathe while on pain medication or experiencing an allergic reaction.
In these instances, the community paramedic can recognize that something serious is occurring, making the distinction between danger and a normal side effect.
Community Paramedicine Provides Resources for Mental Health Care at Home
As we have stated, palliative care does not always mean end-of-life care; however, it may. And anyone undergoing palliative care will undoubtedly have some stress due to their disease or injury. In these instances, there can be many side effects that go far beyond the physical.
For example, someone who has just had a limb amputated will need to adjust to their new environment physically. Still, they will also experience some severe mental effects, which can include serious anxiety and depression.
In these cases, the mobile integrated health team can take several actions. First, they can examine the patient’s entire health picture and ask if anything is missing on the physical side of things. Second, they can coordinate a meeting with mental health professionals to address the psychological aspect of the stress.
Regardless of what the patient needs, the community paramedic seeks to avoid an algorithmic “this is how we always do things” approach and to truly look at the patient, asking: “What do they need right now?”
And as you’ll see, “what they need” isn’t always mental or physical care.
Community Paramedicine Ensures that Social Needs are Met
Many people struggle with social needs that others may not realize. Some of these needs include secure housing, regular good food, and care from friends and family. When people are in palliative care, the last thing they need is to be concerned about their basic human needs being met.
Community paramedics can provide significant assistance in this area. How? Instead of just having the patient answer a questionnaire related to social topics, they can go into the home and ensure that the person has the necessary things.
For example, someone in a hospital setting might ask a patient: “Do you feel safe at home?’ And depending on the situation, the patient may or may not be in a position to answer honestly. Why? Because if the patient has mold in their house or doesn’t have reliable heating in the winter, they may have become accustomed to this deficit and therefore don’t think to mention it when asked by a nurse or physician.
All this changes with the introduction of a community paramedic, who can conduct an active physical inspection of the patient’s home. They can look in the fridge to see if the patient has fresh food, they can check to ensure that there are not significant dangers to their home (like mold or leaky roofs), and they can take it a step further and check to see that the patient has needed mobility aids, such as handrails in the bathroom and a ramp to the front door.
By doing these things, community paramedics can drastically improve the comfort level of patients. Not only can they provide a safety net for mental and physical health, but they can also ensure that the patient is truly comfortable in their own home, giving them the best opportunity to thrive.
Now, let’s discuss one of the more challenging aspects of palliative care – coordinating care among healthcare providers.
Community Paramedicine can Assist Palliative Care at Home by Providing Clear Communication and Reassurance During the Treatment Process
Those who enroll in palliative care often have to fight through a host of assumptions to get the care they really need. The best way to illustrate this is to look at an example.
Take someone who is in hospice and receiving palliative care at the end of life. In this instance, let’s say this patient falls out of bed and breaks their leg so that it is badly misaligned, causing the patient significant pain.
The patient’s loved ones call 911 and report that the patient should be transported to the ER for care. However, when the ambulance arrives and learns that the patient is in hospice, they are met with a host of different opinions. One of the responders says, “Why do you want to go to the hospital–aren’t you in hospice?” Another responder says, “You know, if you go to the ER, they will remove you from hospice care.”
Statements like these illustrate the false assumptions that many providers have about palliative care and hospice. Yes, there are instances where bringing a patient to the hospital can alter the nature of hospice care, but this is highly individualized and depends on the care plan established with the patient, the hospice team, and the patient’s personal physician.
In a case like this, the patient would benefit from going to the ER and having their broken bone at least realigned to reduce pain and discomfort. Yes, the hospital may not suggest surgery, but they will at least be able to make the patient more comfortable than they would be with a badly broken leg. And comfort is the goal.
So how does the community paramedic come into play? The community paramedic can act as a mediator between EMS and the patient, explaining the details of their care plan and providing a clear understanding of exceptions to the typical care path.
Community Paramedicine Can Assist Palliative Care at Home by Helping People Navigate a Complex Healthcare System
Community paramedics can also assist people in palliative care by helping them navigate a complex healthcare system. Those in palliative care who are receiving treatment may need assistance understanding various aspects of their care or help with transportation to and from appointments.
One of the ways that community paramedics help is by working on a safe, central network.
Key Points: Mobile Integrated Health and Palliative Care In the Home
Community paramedics can assist with palliative care at home by providing pain relief, mental and social support, and helping patients navigate a complex landscape. Community paramedics can serve as a vital bridge between patients and providers, ensuring that they receive the best care from the best professionals.
Contact Julota for more insight into how their software tools can help your team build a strong network of providers for those who need palliative care.
