KINGSTON, R.I. — On November 13, Yale University Professor Shelli Feder delivered a compelling address at the URI College of Nursing’s Fall Distinguished Lecture. Speaking at the Rhode Island Nursing Education Center in Providence, she emphasized the urgent need for increased access to palliative care for patients suffering from heart failure, a condition often overlooked in this context.
While palliative care is commonly associated with serious illnesses like cancer or Alzheimer’s disease, it is not as frequently provided to heart failure patients. Feder pointed out that this represents a significant missed opportunity to enhance care for these critical patients. Her lecture highlighted findings from a study conducted within the Veterans Health Administration, which revealed that access to palliative care varies widely among heart failure patients.
Several factors contribute to this disparity. Heart failure is often diagnosed late, making palliative care less relevant at that stage.
Additionally, some local hospital systems lack established processes for referring cardiovascular patients to palliative care providers. To address these issues, Feder urged healthcare facilities to implement specific policies that facilitate timely referrals to palliative care specialists.
“Palliative care is interdisciplinary and holistic,” Feder explained. It focuses on providing comprehensive symptom management and support for both patients and their families. This type of care can be delivered in various settings, including hospitals, outpatient clinics, and even at home. A team of specialists—comprising doctors, nurses, nutritionists, and social workers—works together to enhance the quality of life for patients facing serious illnesses.
Although many associate palliative care with end-of-life hospice services, it is important to note that it can benefit anyone diagnosed with a serious illness at any stage of their treatment.
At URI, nursing students have opportunities to receive training in palliative care through their coursework and by applying for the Susan D. Flynn Palliative Care Undergraduate Fellowship. This specialized program aims to spark interest in palliative care careers and support the professional growth of future nurses in this essential field. The fellowship enhances students’ experiential learning through patient and family care activities, internal meetings, and educational forums.
According to Associate Professor Susan Desanto-Madeya, who leads the fellowship program and is an expert in palliative care, the initiative is “committed to providing person-centered care that aligns with the beliefs, values, and goals of seriously ill patients and their families.”
Desanto-Madeya was recognized as a Fellow of the National Hospice and Palliative Nursing Association in March 2023 and is currently leading a National Institutes of Health-funded study on structural racism in serious illness care.
Professor Feder brings over a decade of clinical experience in hospice and palliative care settings to her role as an educator.
She also serves as the associate program director for the Yale National Clinician Scholars Program and conducts research at the PRIME Center of Excellence in West Haven, VA.
Her research focuses on improving access to high-quality palliative care for individuals with serious non-cancer illnesses like heart failure. Funded by organizations such as the National Institutes of Health and the Department of Veterans Affairs, her work aims to develop innovative models of care delivery that can better serve these patients.
Feder’s address underscored the critical need for timely access to palliative care for heart failure patients. By advocating for improved referral processes and increased awareness among healthcare providers, she hopes to enhance patient outcomes and quality of life for those facing this challenging condition.
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