Androscoggin Home Healthcare + Hospice Nurse Practitioner Amy Hesby. She is part of a program to expand palliative care in the region. Russ Dillingham/Sun Journal

LEWISTON — Palliative care, a strategy for easing the physical and emotional pain of critical illness, is getting a boost from a local agency.

The Maine Center for Palliative Medicine, an offering of Androscoggin Home Healthcare + Hospice, is expanding its services through a fellowship for nurse practitioners.

Hospice, a kind of care for people with terminal illnesses, falls under the umbrella of palliative care, which can be offered to people who are still receiving curative care.

Amy Hesby of Auburn, one of three nurse practitioners appointed for the fellowship, describes palliative care as “a big-picture term to help people sort out what they want for health care options, what makes sense to them. It’s helping people sort out what they need from health care as they get older, and their needs are more complicated.”

The local program is geared toward community and rural practices.

The goal of providers is to relieve symptoms and distress and to help improve quality of life, according to the care agency.

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Nathaniel Sands, who is working toward palliative care certification, said “Often, we find that if we are not ensuring that we know what patients’ values are, we see people move through the system receiving more and more procedures and finding out they didn’t really want this.”  

It describes palliative care as “specialized care that anticipates, prevents, and treats physical, emotional and spiritual discomfort of people with serious illness.”

Patients are helped to understand their conditions. They get information to help them make decisions about their care. Palliative care providers work with patients to help them clarify their goals and wishes, and to define their values, beliefs and priorities, such as whether they want to be resuscitated from cardiac arrest.

“Appropriate for any stage in your illness, palliative care is an extra layer of support that can occur at the same time you are undergoing medical treatment,” according to the agency.

The yearlong nurse practitioner fellowship is in its second year and so far has certified one provider.

This year’s fellows, Hesby and Nathaniel Sands of Portland, are working toward certification at local hospitals. They receive a course of study including clinical work and lessons from faculty.

Their goal as palliative care professionals will be “to deliver compassionate and effective patient-centered care,” according to the agency.

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Part of reaching that goal is to know people’s values, Sands said.

“Often, we find that if we are not ensuring that we know what patients’ values are, we see people move through the system receiving more and more procedures and finding out they didn’t really want this,” he said.

“What does quality of life mean to them? Medical interventions and treatments — someone may not consider that quality of life,” he said.

The difference between hospice and palliative care is not the type of care, Sands said, but a change in philosophy.

“Hospice care includes the understanding that your longevity diagnosis is limited time,” he said.

Hospice is a service for those who have been given six months or less to live. Palliative care can be given as long as a patient wants it, even for multiple issues, he said.

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Jackie Fournier, co-director of the Nurse Practitioner fellowship program for Maine Center for Palliative Medicine, said palliative care is “just about sitting down with a person and having a conversation about what they want.” Andree Kehn/Sun Journal

It’s available in hospitals, clinics, nursing homes and online via telehealth services, said Nurse Practitioner Jackie Fournier, who helped design the program and is co-director of the fellowship.

“Telehealth is able to reach out to rural areas by calling or visiting, depending on the need,” Fournier said.

Palliative care is “just about sitting down with a person and having a conversation about what they want,” she said.

The nurse practitioner mentorship program has been funded through federal grants the past two years. Fellowship applications for a third year are being accepted until Feb. 16.

As nurse practitioners are versed in palliative care, Hesby hopes to see more programs in the future, especially for dementia patients.

“We’re trying to create programs, not hospice, but a similar package of support for people who are trying to live at home,” she said.

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