Porter Medical Center bolsters palliative care

MIDDLEBURY — Porter Medical Center’s main goal during its 90-year history has been to help people heal from injuries and illnesses.
Porter is now partnering with another major hospital to help people close the circle of life, allowing them to die on their own terms and with minimal pain.
To that end, Porter officials on Thursday announced a new partnership with the University of Vermont Medical Center that has secured Dr. Diana Barnard to lead palliative care services at PMC. Barnard has for the past five years presided over UVM Medical Center’s Palliative Care Team.
Barnard will specifically provide direct care to terminally ill patients, primarily at Helen Porter Health Care & Rehabilitation and The Estuary room in the hospital that is reserved for patients in their final days of life. Barnard will also provide some training to local primary care health care providers on palliative care issues.
“We’re starting a new generation of palliative care services,” Barnard said. “The primary goal is to re-establish palliative care in the hospital community, and we’re going to begin by addressing the needs of the most seriously ill … including people admitted to the hospital, and at Helen Porter.”
Barnard needs little introduction to the Addison County community. She is a Weybridge resident who for 15 years was a primary care physician with Middlebury Family Health. She developed an affinity for, and particular talent in, helping terminally ill patients. She and Dr. Will Porter co-founded Partners in Palliative Care, which was very successful during its local, two-year run. Unfortunately, the practice wasn’t financially sustainable under the fee-for-service payment system in health care — a system that is currently changing so that compensation is more reflective of patient outcomes.
In 2011, Barnard joined UVM Medical Center’s Palliative Care Team. She is thrilled to be back practicing medicine in Middlebury.
“It’s no secret that from the day I went to Burlington, I knew I wanted to come back here,” Barnard said.
She was waiting for the right situation, which became a reality earlier this month.
Barnard will continue to be an employee of UVM Medical Center. Her indefinite transfer to Porter Medical Center comes on the cusp of a potential affiliation between Porter and UVM Health Network. As previously reported in the Independent, Porter and UVMHN leaders during the coming weeks will be crunching numbers, reviewing records and holding negotiations that could result in affiliation as soon as this spring.
“This is the first real tangible example of things we hope to do more of (through affiliation),” Porter spokesman Ron Hallman said.
Porter Medical Center has long offered resources for terminally ill patients, but until Barnard’s return did not have a palliative care specialist in the mix. In addition to its Estuary suite, Porter has three rooms at Helen Porter for dying patients, run with support from Addison Respite Care Home Ltd. ARCH is a non-profit organization that supports end-of-life care for terminally ill patients unable to complete their lives at home.
“Facilities only go so far,” Hallman said. “We haven’t had a specialist. We have really great nurses who provide excellent care, and having Diana’s expertise is going to be key.”
Since an average of around 80 people die at Porter Hospital and the nursing home each year, according to Hallman, PMC officials want to make sure those patients have as much control as possible over their final days.
“It is really a classic community hospital service,” said Porter Medical Center President Dr. Fred Kniffin. “If we acknowledge that death is going to happen on a regular basis in our community hospital and nursing home setting, we should make every effort to provide this end-of-life service, as with all services, in a patient-centered and compassionate manner.”
SPECIALIZED CARE
Barnard described palliative medicine as a “specialized kind of care designed to maximize quality of life for patients and families who are living with serious or life limiting illness. The primary goal of palliative medicine is to anticipate, prevent and treat suffering, in it’s many forms.”
Palliative care includes hospice services — and a lot more, according to Barnard. It involves meeting people at an earlier point in their illness, and providing quality of life, addressing suffering, talking through treatment options and deciding what is best for the patient.
“It’s understanding individual patient values and the reality of their medical condition, and blending those into a treatment plan that is patient-centered and likely to be successful,” Barnard said.
“It’s very challenging,” she added. “Palliative care is almost always provided with an inter-disciplinary team. It’s like I’m part doctor, part nurse, part social worker, part psychologist, and I’m pulling all of those skills together to be able to help patients and families. It is incredibly rewarding and important.”
Hallman is pleased PMC is now able to add a key, new amenity for patients.
“(End of life care) is something that’s going to happen here, and we want it to happen with expertise, with the right professionals, and the right facilities,” Hallman said. “The over-arching message here — besides the fact we couldn’t do this without UVMHN’s assistance — is that this is really a core service we want to do really well. Now that we have Diana helping us, we’re really excited.”
Reporter John Flowers is at johnf@addisonindependent.com.

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