Zara Cooper

Discipline: Physician

Funding awarded to: Brigham and Women’s Hospital, Boston, Massachusetts

Identifying Palliative Care Needs of Older Adults Undergoing Emergent Abdominal Surgery

The project will identify palliative care needs among surgical patients and highlight opportunities for them to reap palliative care benefits, which are widely accepted in other seriously ill patients. The goal is to take a population of vulnerable, older surgical patients known to be at high risk for poor outcome, advance their palliative care needs, and create a road map for providing palliative care to high risk surgical patients. A big challenge for palliative care is defining a role for itself outside of patients with cancer and known terminal illnesses. A big challenge for us in surgery is identifying patients who will most benefit from palliative care and understanding the processes to integrate palliative care with surgical care. While a higher number of older patients with a serious illness are undergoing surgery, palliative care in surgery is still in its infancy. Surgeons need to take lessons learned from other fields and become more competent in providing primary palliative care and increasing access to palliative care and hospice to patients who could benefit.

My interest in palliative care began as a surgical critical care fellow. I witnessed immeasurable suffering among clinicians, patients and family members when patients either died or left the ICU so impaired that death was imminent. While some of my colleagues declared victory when these patients were discharged to a long-term care facility, I worried that we failed to value goals other than survival. Seeking alternatives to what I considered unintentional patient and family abandonment, I chose to become one of the few surgeons nationally who is board certified in hospice and palliative medicine.