The way we die in America has changed rapidly over the past century. It used to be that the choices Americans made at death were simple and straight forward, there was a cure or there was not. Today, however, the top three leading causes of death in the United States are heart disease, cancer, and chronic lower respiratory diseases. These diseases represent chronic terminal illnesses that have a wide range of treatment options. The waters of care have gotten mucky, and navigation requires knowledge and education. This is where home health care can help by providing resources and support to patients that would otherwise not have access to comprehensive health care. Traditionally when we think about death we think of a diagnosis that is followed by a rapid decline in health where patients either die at a hospital, at home in hospice or another similar program. Fidelity Health Care supports patients at home in the time between diagnosis and decline. Within the greater umbrella of Fidelity’s home care operation is the Premier Health Advanced Illness Management Program (PHAIM). The goal of the  PHAIM team is to support patients in managing their illness, improve patients’ quality of life and keep them out of the hospital. This is done in the end stage of terminal illnesses ideally before a patient needs to be in hospice care
Until this co-op I had never considered what happens to patients with chronic diseases before they are placed in the care of hospice. It has been an amazing privilege to learn about care in late stage illness from the interdisciplinary PHAIM care team. The PHAIM care team facilitates home care of chronic illness with home visits from doctors, nurses, social works and health coaches. In addition to helping patients manage their illness, the PHAIM team continually supports patients with conversations about what their goals are as well as ensuring that paper work, such as do not resuscitate (DNRs) forms (which is in place so that these patients can retain control over their dying process). In my eyes, the most powerful part of the type of care PHAIM team provides is the continued dedication to educating their patients. The care enables patients to fully participate in the care they receive, instead of expecting them to passively follow orders.
Over this co-op thus far, I have largely been assisting with office work such as creating numerical spreadsheets with information to help show what the PHAIM team can do. Â This work might sound boring, but to me to be able to take something as amazing as what the PHAIM team does and justify it numerically. The spreadsheets show the work that the PHAIM team has been doing and has the potential to assist in acquiring the team better funding. Showing that they improve the quality of life for their patients is an invaluable experience for me, not only am I learning and working with valuable data skills. Even looking through 500 patients charts for a few data variables knowing that it helps, in some small way, to make what the PHAIM team possible makes it a valuable experience for me. The incredible care the PHAIM team gives is something that I hope to carry forward with me into my career in Health Care. PHAIMs care is an example of the healing power of a compassionate and nonjudgmental treatment.
