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Supportive Care Pearls

=Images= | Dr. Sawicki Head Shot - Cropped Robert Sawicki, M.D., Medical Director of OSF Home Care Services shares his Pearls of Wisdom regarding Supportive Care. To learn about Dr. Sawicki, please click here.

News You Can Use

OSF Supportive Care Initiative Featured in Local Health Publication
Dr. Sawicki and the Supportive Care Initiative was featured as the cover story in the April 2009 issue of Healthy Cells, a local Peoria healthcare publication. To read the article, please click here.

Dr. Sawicki Earns CAQ Award
Dr. Robert Sawicki, Medical Director of OSF Home Care Services and Medical Director of Supportive Care for OSF HealthCare, recently passed the 2008 Hospice and Palliative Medicine Certification Examination.

As a result of his successful performance, he has been awarded a Certificate of Added Qualifications (CAQ) in Hospice and Palliative Medicine. This certificate from the American Board of Family Medicine, Inc. is valid until October 29, 2018, and is designed to recognize excellence among physicians who emphasize the care of seriously ill and dying patients with life-limiting illnesses in their practice.

For more information on Dr. Sawicki, click here.

The Physician's Role in the Care of Patient's at Home

Article by Dr. Robert Sawicki, Medical Director of OSF Home Care Services and Medical Director of Supportive Care for OSF HealthCare

Very few doctors receive training in the care of the patient outside of the walls of the hospital or office setting. While most of us don't make house calls, it is important to understand that the vast majority of patients' lives are spent in the home, not in the hospital. A patient with a chronic, progressive illness may have frequent trips to the formal medical setting, where we as doctors can assess and treat their acute needs, but it is truly in the home where life happens.

Patients who meet the appropriate criteria can be served by OSF Home Care Services. These patients are often not able to get out of the house except in dire circumstances or with great difficulty, so the Home Care staff can serve as the physician's eyes and ears. Doctors still must decide treatment and give orders, but can rely on the clinician seeing the patient to assess their condition. Clinicians often develop a close relationship with the patients, and can detect subtle changes that can help identify problems early. Changes in the plan of care can then be made by the physician with the help of the clinician, and this can avoid unnecessary trips to the hospital or emergency department.

Patients are coming home from the hospital quicker than ever before, and are sometimes ill prepared to deal with their condition outside the controlled environment of the hospital. OSF Home Care Services eases that transition, giving them the security of skilled professionals to assess them, and help them along the road to recovery. In patients who are declining, hospice may be the most appropriate service for them. Caring people can help them deal with their condition and manage their symptoms, so that they can truly live each day to the fullest.

Physician House Calls are available to patients of OSF Home Care Services. While not an urgent or emergent care service, having a physician see your homebound patients can assist you in their management, and can offer patients a great peace of mind as well.

November is National Home Care and Hospice Month

Article by Dr. Robert Sawicki, Medical Director of OSF Home Care Services and Medical Director of Supportive Care for OSF HealthCare

The death rate among the patients you see in your practice has not changed in many years; it is still 100%. As physicians, we are trained to do everything within our power to cure disease, and the advances that have been made over the last 100 years show huge increases in life expectancy, such that a recent article reports that those born in the 21^st Century will have a greater than 50% chance of living to 100 years of age.

Associated with the increased life span and reduced death rate from acute illness, we see an increase in chronic progressive disease. This is a type of disease that we can manage, but never cure. It will inevitably worsen, and our patients will become more debilitated. We can often rescue them from their acute exacerbations, but eventually, the disease will prevail. This is not a failure on our part, but simply an outcome of our biology.

As patients get progressively worse with these illnesses, there is generally a time when it is no longer beneficial to return to the hospital for aggressive treatment. Patients then wish to focus on their own comfort, and when death approaches, they do not turn it away. This is where hospice is a help. Because they are focused on feeling better, they avoid the stresses of multiple office or hospital visits, testing that doesn't change therapy or illness trajectory, and instead spend time with loved ones. It has been said that as death approaches, the medical aspects of our lives become less and less important. In fact, in some cases, studies show that patients who elect hospice care actually survive longer than those who continue aggressive treatment.

Hospice is NOT just those final hours or days. It is for the last phase of life's journey, which can take months. We as physicians tend to be overly optimistic about our patients' prognosis, especially if we have been with them for a long time. This is a natural, expected phenomenon. It is helpful to think of this question when seeing someone with chronic progressive disease: "Would I be surprised if this person died within the next year?" If the answer is no, you wouldn't be surprised, you should consider a referral to hospice. Hospice can help you help them.

More and more people are electing hospice as they complete their life's journey. They experience a caring team of experts whose primary focus is "how can I be of help". For more information about hospice, or to make a referral, call 800-673-5288.