Wednesday, January 30, 2013

What's in a Name: The Branding Issues of Geriatrics and Palliative Care


One common issue that comes up in both palliative care and geriatrics is how to address the lack of name recognition our fields have in the general public.  The reality is very harsh, as both terms have really little to no meaning for most health care consumers.  For instance, in a 2011 survey conducted by CAPC, 70% of participants were "not at all knowledgable" about palliative care.

To drive home this point, some very inspired researchers at Johns Hopkins Division of Geriatric Medicine and Gerontology, including Jean Campbell, Samuel Durso, Lynsey Brandt, Thomas Finucane, and Peter Abadir, have published an entertaining yet disturbing picture of what a random sample of individuals think the word "geriatrician" means.

The authors went through downtown Baltimore with a video camera and a consent form.  They interviewed 82 individuals, of which only 8 (10%) heard of the term “geriatrician.”   The other 90% never heard the term but did give their best guess about what a geriatrician does.  Even though nine were able to guess correctly that a geriatrician was a healthcare provider for elderly adults, the rest guessed so terribly wrong.  These responses are nicely compiled in the following video (which can be downloaded on the JAGS website):




This video got us thinking, what would happen if we went around asking the same question about palliative care.  What do you think the answers would be (or what have you heard)?

by: Eric Widera (@ewidera)

5 comments:

Christian Sinclair said...

I've actually thought of doing that in NOLA at the conference. I'll bring my video camera if you want to do it Eric.

Anonymous said...

I think we already know what we woud hear if the public were asked about palliative care. I think it would be much more interesting (& telling) to hear how palliative providers "define" palliative care.

Jim Siegel said...

Eric – thanks much for this post. Christian – great idea to build on this for palliative care. Almost always when I ask people if they are familiar with the term palliative care, the answer is either “no” or solely about end-of-life. No surprise in either case. I then explain: “Palliative care encompasses the whole person – body, mind, and spirit. It’s appropriate when receiving treatment intended to cure, for when an illness is chronic, or near end of life. Palliative care relieves suffering and matches treatment to what the patient and family choose based on knowing and understanding what those choices are.”

When I ask on behalf of the HealthCare Chaplaincy organization: “Did you know there are professional health care chaplains who can help you cope with a health crisis whether you’re religious or not?” the answer usually is “no.” I then explain, “Let’s assume everyone has a source of spiritual strength which may or not be grounded in religious belief. Professional chaplains help people identify and draw upon that spiritual strength to find meaning and comfort while doctors and nurses focus on the body.”

Kilgore Trout said...

Great Jim, nice definition. We so often read the following: Palliative care is a medical specialty....provided by doctors, nurses and other professionals and provides XYZ (medical interventions relating to physical needs) to provide comfort. To me this is Palliative Medicine definition and probably relates to what is being provided in most inpatient settings. We need to be mindful and careful with what words we use. Words shape realiy and we have enough confusion in trying to explain what palliative care is. This palliative medicine definition does not take into consideration the "reality" of the comprehensive needs and issues that befall patients and their families as they deal with illness, dying, death and grief at home, among family and friends and in the community where they live. What about the chaos that ensues with individual family members and te entire family system when the matriarch or breadwinner becomes infirmed, dies? What about caregiving and coping with the physical, emotional, psychological, spiritual, existential, financial and grief issues of a loved one and family while Life is still happening? What about the coping that goes along with living in limbo when the illness does not progress as precribed? What about the psycholgy of living day to day watching your love done slip away? Or the profound mental process that goes along with transitioning from cure to comfort choices?
These are the issues that require the expertise of not only spiritual care providers,doctors and nurses, but also social workers, bereavement specialists, grief counselors and other members of the interdisciplinary team. Quality outcomes for patients and family driven "palliative care" comes only with a true holistic team approach.
Anything less should be called something else.
AMEN.

Wendy Adams said...

I'd like to see that study repeated at a convention of health care administrators.