When critically ill people learn that they have beaten the odds and their potentially fatal disease has gone into remission, their first reaction is probably overwhelming joy. But what comes next? How does one adjust to the aftermath of serious illness?
Regence BlueCross BlueShield (BCBS) believes that extending palliative care to patients in remission is the answer. The insurer, which offers coverage in Idaho, Washington (select counties), Oregon and Utah, recently launched what it calls the first structured palliative care program for patients in remission.
“One day … your disease is inactive. You may or may not be ready to embrace a new definition of yourself as ‘well,’” Lee Spears, program director at Regence BCBS Palliative Care, tells AARP.
For example, a patient may think that every time he gets indigestion or has a backache or headache his cancer has returned, Lee says, and may need professional assistance in dealing with those concerns. Under Regence’s program, the patient decides when to leave palliative care. “This is more than patient-centered care; it is patient-directed care.”
Palliative care typically integrates multidisciplinary care teams — including physicians and nurses, social workers, mental health professionals and chaplains — who offer tailored treatment plans focused on improving quality of life for patients facing a serious illness. It can be delivered at home or in facilities, but it is not hospice care — patients can still be receiving treatment and, in some cases, go into remission.
Caregivers need support, too
The palliative services are also available for caregivers of the patient, even if they are not enrolled with Regence. “When a spouse is taking care of you, the illness is part of their daily life, as well," Lee says. "It can be difficult for a spouse to let go of that role. Emotional and spiritual support are necessary.”
While Regence may be a leader in the field in offering this type of structured program, other insurers are offering palliative care at all stages of illness, including remission. These insurers include CareOregon and Priority Health, which serves members in Michigan.
“In the hopeful likelihood that a patient goes into remission, I feel very strongly palliative care can be very helpful for them,” Gregory Gadbois, M.D., medical director of Priority Health, tells AARP. Palliative care can also help patients deal with side effects from treatments, he adds.
Patients in remission at some point thought they might die. “It’s a huge adjustment," Gadbois says. "Palliative care is perfectly set up to help those patients during the treatment — and, hopefully, afterward in remission — to grasp, 'What does this mean to me going forward?'”