pallative

This episode of the Cancering Show focuses on the importance of caregivers in the cancer journey. Dr. Jennifer Young Pierce talks with Dr. Nick Dionne-Odom, associate professor in the School of Nursing at the University of Alabama at Birmingham and co-director of Caregiver and Bereavement Support Services in the UAB Center for Palliative and Supportive Care. They discuss what it means to be a caregiver, how caregiving for someone with a terminal diagnosis is different from caring for those with earlier stage cancers, the physical and mental toll that caregiving can take, and the resources available to help caregivers. 

Plus, Dr. Nick Dionne-Odom discusses his research on cancer caregiving. Dr. Dionne-Odom has developed several programs to help family caregivers of cancer patients manage stress and cope with the challenges of caregiving. He discusses his research findings, which show that these programs are beneficial for caregivers, and provides advice on how family and friends can help caregivers. He also talks about the importance of having access to one-on-one support for caregivers, no matter where they live. Lastly, he discusses the grieving process and the types of support available for those who have recently lost a loved one.

"We find that many caregivers that we work with have this feeling that they need to be available 24/7 to this person, be there at all times, and that all activities, all priorities need to be centered around the patient. If one does that and you do not take care of your own health, that is not a sprint; it is a marathon. And being able to take care of yourself is actually a very important way that you can take care of this person." 

– Dr. Nick Dionne-Odom  

Episode Takeaways: 

Caregivers are essential in the cancer journey. 

Caregiving for someone with a terminal diagnosis is different than caring for those with earlier stage cancers. 

Caregiving can have a physical and mental toll on the caregiver. 

It is normal to feel anxiety and depression when caring for someone with cancer. 

There are resources available to help caregivers. 

Dr. Dionne-Odom has developed programs to help family caregivers of cancer patients manage stress and cope with the challenges of caregiving.

Caregivers often experience isolation and may not want to burden their social networks. 

Offering specific types of assistance (e.g. cutting the grass, walking the dog, picking up the mail, doing the laundry, making meals etc.) is more likely to be accepted. 

There is no one-size-fits-all approach to grieving. Everyone processes loss differently, and it can take months and even years to go through the process. 

There is support available for those who have recently lost a loved one, such as the Medicare hospice benefit.

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The Cancering Show is brought to you by USA Health Mitchell Cancer Institute. MCI is a cutting-edge cancer research and treatment center built to fight cancer smarter in Mobile and Baldwin counties in Alabama. Our researchers and clinicians focus daily on the struggle against cancer, serving a potential catchment population of more than 4.1 million people, with a singular focus of advancing cancer diagnosis, treatment, and prevention throughout the Gulf Coast and beyond with science, technology and hope.

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Seasons Hospice & Palliative Care engenders hope in the lives of its patients and their family members. A community-based organization, Seasons Hopsice is on an ongoing mission to find creative solutions which add quality to life. Through the firm belief that individuals and families are the experts in their own care, we focus on the patient and family experience and empowerment.

Our Guest

Balu Natarajan, M.D. is a graduate of Northwestern University Medical School and has been the Chief Medical Officer of Seasons Hospice since 2005. He served in various capacities for Seasons from 2000 until 2005, including holding the position of Medical Director of the Illinois program.

Board-certified in internal medicine, hospice and palliative care, and sports medicine, Dr. Natarajan has authored book chapters and articles in peer-reviewed journals. He has also lectured across the United States and around the world, including at the Annual Meeting of the American College of Physicians. He won the Scripps Howard National Spelling Bee in 1985.

Here are the highlights of our conversation with our guest:

• Dr. Natarajan loves helping people and he learned early in his career that he is one of those physicians who can inspire other physicians to be better or to improve their workday to be able to do more for people. His current role in Seasons Hospice allows him to support 4700 patients a day through hundreds of physicians, hospice aids, social workers, nurses, chaplains and other team members who work together.
• He loved technology as he was growing up and thought he would be doing computer or software work. When he was 16, he went to a science show and one of the sessions featured a cardiologist who passed around an artificial heart after talking to them about it. He was hooked to science the moment he held that heart in his hand.
• His accidental journey to Hospice started when he needed a job for a year when his wife needed to go somewhere for school.  He became a hospitalist for a year taking care of hospitalized in patients. He found himself referring patients to Hospice then did a talk one night during a team meeting, and it involved from there.
• Hospice is based in Chicago, Illinois and had just turned 20 years old. They are a joint commissioned Medicare certified hospice and their job is to take care of patients with life expectancy of 6 months or less. They are the largest employer of music therapists across the country and have a foundation which supports their patients non-medical needs. The communities they serve are generally urban and sub-urban markets. They serve 4700 patients a day in 29 cities from coast to coast.
• Dr. Natarajan’s focus is patient experience and he has all the support of all the doctors as well as the Nursing and Education and Quality Support of Care departments.  His team takes this incredibly seriously and what they have been working on right now is getting the right person to the right patient at the right time, given the backdrop of short length of stay. Basically, this pertains to how they can serve to those who are acutely in need who just came into the program, and at the same time, getting to the people that they have been taken care of for months now. It’s not an easy thing to do and they are hoping that technology can have a huge impact on their ability to do this.
• He believes that the areas where technology can really make an impact on in their field is acuity scale, patient perceptions and developing a tool which can take all the triages and determine which patients need to be prioritized overlaid with geography.
• The challenges they are encountering right now in applying technology include connectivity (which is the biggest), rules and regulations which clarify which is a visit or not, and other logistical, legal and technological barriers.