Five Questions With: Dr. Jennifer Ritzau

Dr. Jennifer Ritzau works with critically ill patients and their families at Hope Hospice & Palliative Care Rhode Island. / COURTESY BECKY SIZELOVE, HHPCRI
Dr. Jennifer Ritzau works with critically ill patients and their families at Hope Hospice & Palliative Care Rhode Island. / COURTESY BECKY SIZELOVE, HHPCRI

Dr. Jennifer Ritzau is director of palliative care and associate medical director at Hope Hospice & Palliative Care Rhode Island, formerly known as Home & Hospice Care of Rhode Island. A resident of Dayville, Conn., she has been employed by Hope Hospice RI since January 2009. Ritzau talked recently with Providence Business News about hospice care, palliative care and Hope Hospice RI’s newest endeavors.

PBN: What is palliative care and how does it differ from hospice care?

RITZAU: Palliative care is a specialized form of medical care that provides relief from the symptoms and stress of a serious illness. When a serious illness affects a person or his or her loved ones, it can be a very difficult time for all involved. Palliative care providers work to improve quality of life for both patients and their family members. Working with the existing health care team, palliative care specialists seek to provide an extra layer of support to families and patients struggling with the burdens of serious illness. Our team works to improve symptoms like pain, nausea, fatigue and shortness of breath.

We help families have a clear understanding of their loved one’s illness and treatment options, so that, together, patients and families can decide what is most important to them. From there, our team can modify the patient’s care plan to match his or her goals for care. Palliative care has helped patients living with serious illness live longer, better lives, despite their illness, by bringing the focus on quality of life and improved understanding of illness. It’s important to note that patients do not have to give up on curative treatments for their illness while receiving palliative care.

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When illness progresses, hospice care is a specialized form of palliative care that brings together a team, including nurses, chaplains, social workers, hospice aides and volunteers to provide intensive support to patients who are in the terminal stages of a serious illness and their family members. The focus becomes comfort and easing of symptoms and ramping up spiritual and social support for family caregivers. Usually, hospice care is limited to those who have chosen to stop receiving disease-directed therapies like chemotherapy, radiation and dialysis. A major part of the benefit, which many people are not aware of, is a full year of bereavement support to the patient’s family after the patient has died.

PBN: Why is Hope Hospice RI expanding its services by opening a palliative care unit near its Philip Hulitar Hospice Center and collaborating with South County Health to provide palliative care there?

RITZAU: We are so excited that the Hope Palliative Care Center will be the first freestanding palliative care outpatient clinic in Rhode Island. It is the next logical step to provide continuous care for people with serious illness in Rhode Island. Hope Hospice RI already provides inpatient palliative care to patients at Lifespan’s Rhode Island, The Miriam and Newport hospitals, and has recently partnered with South County Health to provide inpatient palliative care. In addition, we have a palliative home care program with Visiting Nurse of HopeHealth, formerly known as Visiting Nurse Home Care, and South County Home Health. We also can care for palliative patients who are living in long-term care facilities, including nursing homes. Until now, if you were not home-bound or in a hospital or long-term care facility, we could not see you. Our outpatient clinic expands our reach to anyone living with serious illness who wants us to help with his or her care.

Hope Hospice RI has been a leader in the state for both hospice and palliative care. We have been providing hospice care for more than 40 years and palliative care for 13 years. South County Health recognized an unmet need for palliative care with their most seriously ill patients and reached out to us. We are delighted to partner with South County Health, which is deeply engaged in its local community to provide inpatient palliative care. They organization shares our passion for and commitment to high quality, patient-centered care, and I am certain that, by working together, we can achieve wonderful results.

PBN: What are the most common misperceptions about palliative care, and how does Hope Hospice RI work to educate the community about palliative care?

RITZAU: There is a growing awareness of the benefits of palliative care, not only to improve the quality of life for patients facing serious illness, but also to increase the value of care that is delivered to them. However, some may think that palliative care is a euphemism for hospice care or end-of-life care, which is not the case at all. Palliative care should be started as soon as patients are diagnosed with a serious, life-threatening illness because there is so much we can do to help. Because palliative care does help manage pain, some may confuse our expertise with pain clinics. Our skills are directed toward patients who have serious medical conditions rather than chronic pain that may not be in the context of a serious illness. The Hope Palliative Care Center will see anyone with a serious illness so that they can have access to expert palliative care in an outpatient clinic setting.

PBN: What types of medical conditions would make someone a candidate for palliative care, and what environment is best for palliative care – at home, in a hospital or some other environment?

RITZAU: We see cancer patients at all phases of their illness. In addition, we are able to help with more chronic conditions like heart failure, emphysema and renal disease. We often see patients with more than one complex condition; individually, each condition may not be serious, but in combination with other conditions, it has a major impact on patients’ health. Patients living with a neurologic illness like dementia, chronic strokes, ALS and multiple sclerosis can also benefit from palliative care. What’s most important is that patients and families realize how helpful palliative care can be, and request this service wherever they are. Some patients will receive palliative care while in the hospital, others by a home-based palliative care team. The Hope Palliative Care Center allows patients and families to make the choice to have this kind of care, regardless of their setting. Wherever you are, we are here for you.

PBN: What types of insurance typically cover palliative care and for how long?

RITZAU: Palliative care consultations are covered by most insurance programs, just like any other specialist might be involved in your care. Although the issues we address may be different, seeing a palliative care provider in the hospital or in an outpatient clinic is no different than seeing a gastroenterologist, cardiologist or oncologist and is paid for in the same way. There is no limit to how long a patient can be supported by palliative care.

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