24 December 2008

U.S. Specialists Bring Palliative Care Training to Ukraine

Country building capacity to care for those with “life-limited” illness

A resident of the Geriatric Center in Kiev asks Mary Wheeler, at left, if she can join in the palliative and hospice training program.

By Kathryn McConnell
Staff Writer

Washington — In poor countries around the world, health-care policymakers and practitioners are increasingly aware that quality of care for patients with “life-limited” illness and their families is a public health issue.

And increasingly, health-care leaders in those countries want to learn from international specialists like Americans Frank Ferris and Mary Wheeler how best to give that care.

Ferris, a physician and the director of international programs at the Institute for Palliative Medicine at San Diego Hospice, and Wheeler, a clinical nurse at Community Hospice in Washington, recently led a three-week training session in Ukraine in clinical methods in providing hospice and palliative care.

Ukraine, like other countries in Central and Eastern Europe and the former Soviet Union, is experiencing an aging population, a growing incidence of cancer and an emerging HIV/AIDS epidemic, according the Open Society Institute, one of the sponsors of the November training.

End-of-life care requires a range of health-care specialists that includes doctors, nurses, social workers, home care providers, administrators, pharmacists, clergy and volunteers. Palliative care focuses on the relief of suffering at any time during a “life-limited” illness, which includes conditions for which treatment may still be feasible. Hospice is a component of palliative care that also focuses on the relief of suffering, caring for the patient and family during the latter stages of the illness.

 

Mary Wheeler, second from left, and a group of health care specialists visit a patient at the Oncology Hospice in Ukraine.

Mary Wheeler, second from left, and a group of health care specialists visit a patient at the Oncology Hospice in Ukraine.

Ukraine's health ministry is committed to building the country's capacity to provide such care to patients, Wheeler told America.gov. The ministry, Ukraine's National Medical Academy for Postgraduate Education and the International Renaissance Foundation, a member of the Soros network of foundations, were partners in the training.

Guiding such capacity requires training in such areas as managing pain; counseling patients nearing the end of their lives and counseling their families in grief and loss; and medication pharmacology, including how medicines interact with the body, Ferris told America.gov. Wheeler added that often the trainers used role-playing as a teaching method.

Training further involves how to tell patients and families about the end-of-life process, easing a fear that telling patients the truth about their situation would mean loss of hope and earlier death.

The training emphasized the strength of teamwork in providing care and appreciation for the different skill sets of physicians and nurses.

The learning "was transformational" for many of the nurses and physicians in the training, who initially were reserved about taking skills they learned in the classroom to a bedside setting, but at the same time were eager to learn, Ferris said.

Over recent years, Ferris and Wheeler have been invited to work with governments and large health-care systems in Jordan, Egypt, Mongolia, Saudi Arabia, Georgia, Moldova and Vietnam to help them to build their palliative care infrastructures. Their work has been supported by various partners, including Open Society Institute, San Diego Hospice, Community Hospice of Washington and the U.S. National Cancer Institute.

Established in 2000, the Open Society Institute's International Palliative Care Initiative aims to establish an international network of individuals and groups committed to improving care for people with life-limited illness and their families through funding and technical assistance.