PULMONARY , ALLERGY , AND CRITICAL CARE MEDICINE QUARTERLY UPDATE
SPRING 2023
FEATURE STORIES
Iyer Advocates for Palliative Care in Pulmonary Settings by Andy Currie
While 92 % of Americans say it ? s important to discuss their wishes for end-of-life care , only 32 % have had such a conversation . As an intensivist and pulmonary assistant professor , Anand Iyer , M . D ., knows this quite well . He ? s been having conversations about serious illness with patients and their families for over a decade .
Early in his training , Iyer began integrating palliative care principles into his rotations in the ICU . Now , he is parlaying those efforts into a blended # pallipulm approach to the full tripartite mission : research , education , and care .
? People living with serious respiratory illnesses , such as COPD , suffer with many significant symptoms , like progressively debilitating breathlessness , and have poor prognostic awareness about the future . Over half of adults with COPD will be older than 75 years in the next decade , and many of them have significant care needs like functional issues , difficulty with mobility , and social isolation ,? Iyer explains . ? Plus , it ? s really hard for them as they get older to lug a heavy oxygen tank around , which makes things like walking to the mailbox a difficult experience . COPD is much more than inhalers , and a patient ? s family really feels the burden , too .? recently designed a # pallipulm intervention for patients and their families . ? EPIC : Early Palliative Care in COPD ,? is a first of its kind # pallipulm program that uses telephonic
Anand Iyer , M . D . discusses end-of-life care plans with a UAB employee . Photography : Carolyn Walsh
palliative care nurse coaching to guide patients living with COPD and their families through a curriculum of problem solving , symptom recognition and management , aging well with COPD , and planning for the future .
Iyer is now testing EPIC through a pilot randomized controlled trial at UAB . He hopes that EPIC can help patients and their families learn skills they need to take more control over their COPD , improve quality of life , grow older more successfully , and have those important conversations about the future long before the end of life .
Recognizing how often this chronically ill population experiences a chaotic end of life with frequent hospitalizations , Iyer joined forces with the UAB Center for Palliative and Supportive Care to support UAB ? s observance of National Healthcare Decision Day .
On April 16 , patients across both UAB Hospital campuses were invited to learn more about how to begin those important conversations prior to an emergency or end-of-life crisis . Each one was given a simple booklet to guide them in thinking about future goals of care and serve as a reference when health decisions need to be made .
? The population of older adults is growing fast , and we all need to be thinking outside the box on ways to help them plan for the future and live well , especially with complex serious respiratory illnesses that limit their quality of life ,? Iyer says .
If you didn ? t join the national observance of Healthcare Decision Day , it ? s not too late to start the conversation . Visit theconversationproject . org to find plenty of resources for patients and providers alike .
And that ? s just the tip of the # pallipulm iceberg . As a Beeson Scholar and Emerging Leader in Aging , Iyer
PULMONARY , ALLERGY , AND CRITICAL CARE MEDICINE