KINGSTON, R.I. — Nov. 14, 2024 — While palliative care is common for patients diagnosed with life-threatening conditions like cancer or Alzheimer’s Disease, it is less commonly prescribed to patients suffering from heart failure, a missed opportunity to provide enhanced care for those critical patients, according to Yale University Professor Shelli Feder, who addressed Rhode Island nurses, students and professors during a lecture on Nov. 13.

Delivering the URI College of Nursing Fall Distinguished Lecture at the Rhode Island Nursing Education Center in Providence, Feder detailed a study involving patients in the Veterans Health Administration that shows access to palliative care varies widely among patients suffering from heart failure. Reasons vary from heart failure often being diagnosed late, rendering palliative care irrelevant, to some local hospital systems lacking processes to refer cardiovascular patients to palliative care providers. Feder urges medical facilities to adopt specific policies for referring patients to palliative care to help guide providers’ behavior toward timely referral to palliative experts.

Palliative care is interdisciplinary, holistic care for patients with life-threatening conditions that provides enhanced symptom care and additional supports for patients and their families, Feder said. It can be provided in a hospital, during outpatient visits, or at home, and involves a team of specialists—including doctors, nurses, nutritionists, social workers and more—who focus on ways to improve quality of life for patients and their families. Although often associated with hospice care, which focuses on the final months of life, palliative care can be offered to anyone diagnosed with serious illness.

Nursing students at URI have access to palliative care training in regular coursework and by applying to the Susan D. Flynn Palliative Care Undergraduate Fellowship. The specialized fellowship program is intended to stimulate career interest and foster the professional development of much-needed future palliative care nurses. The program is designed to enhance students’ experiential learning opportunities, including patient and family care, internal meetings and educational forums.

The program is “committed to providing person-centered care that is based on the seriously ill person and family’s beliefs, values, and goals,” according to Associate Professor Susan Desanto-Madeya, the College’s Miriam Weyker Chair, who heads the program. Desanto-Madeya is an expert in palliative care, and was named a Fellow of the National Hospice and Palliative Nursing Association in March 2023. She is principal investigator of a National Institutes of Health RO1-funded study on “Structural Racism and Engagement of Family Caregivers in Serious Illness Care.”

Feder is also an expert in palliative care with more than a decade of clinical experience as an advanced practice nurse and nurse practitioner in hospice, palliative care and cardiovascular settings. In addition to teaching nursing, Feder is the associate program director for the Yale National Clinician Scholars Program, and an investigator at the PRIME Center of Excellence in West Haven, VA.

An organizational health services researcher, Feder’s research interests include palliative and end-of-life care for people with non-cancer serious illness, health policy related to palliative and end-of-life care, medical informatics, and digital health interventions. Funded by such organizations as the National Institutes of Health, the Hartford Centers for Gerontological Nursing Excellence, the Palliative Care Research Cooperative, and the Department of Veterans Affairs, her research aims to create innovative models of care delivery that improve access to high-quality, timely palliative care for people with cardiopulmonary conditions.

The URI College of Nursing hosts its Distinguished Lecture Series each semester. Past lectures have been delivered by famed founder of the global health initiative, Partners in Health, Dr. Paul Farmer; former American Nurses Association President Ernest Grant; Director of the National Institute of Nursing Research Shannon Zenk; and Pennsylvania State University nursing Professor Susan Loeb, among others.