Alabama ranks low in care for the sick

Alabama received an "F" on a state-by-state report card grading how it cares for its sickest patients, and there are wide disparities nationwide.

The research, which was conducted by the Center to Advance Palliative Care, appears in this month's Journal of Palliative Medicine.

"Americans are living longer - but with serious illness," Dr. Diane Meier, director of the center and co-author of the study, said in a public release. "Without palliative care, people with serious illnesses, like cancer, often suffer unnecessarily from severe fatigue, pain, shortness of breath, nausea and other symptoms from their disease and treatments."

Palliative care is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms.

Shoals residents, however, might be better off than many others around the state where palliative care beds in local hospitals are unavailable. Only seven counties in Alabama - Cullman, Geneva, Jefferson, Lauderdale, Lee, Mobile and Montgomery - are equipped to treat the end-stage symptoms of some diseases.

At Eliza Coffee Memorial Hospital in Florence, there are four beds dedicated to palliative care for patients and a fifth expected to become available at the end of the month.

Michelle Willingham, a patient care manager, said facilities within a hospital setting serve a purpose in the overall health care of the community.

"Our role is often to get a patient's pain under control and get them to where they can function at home," she said. "They might get home, do better for a while and have to come back because they can't control their symptoms."

The study further suggests that more hospitals across the country are looking to add palliative care services. In 2000, for instance, only a few hospitals provided this kind of care. Just a few years later, larger facilities with more than 249 beds were regularly adding the service, especially in the West and Midwest.

"The good news is that hospitals nationwide have implemented palliative care programs quickly over the last six years," Sean Morrison, director of the nonprofit National Palliative Care Research Center and senior author of the study, said in a public release. "The bad news is that, if you live in the South or you have to rely on public or community hospitals, you're in trouble."

The Shoals aside, there are larger, more metropolitan areas, including Huntsville and Tuscaloosa, that lack these kinds of services.

For their part, hospital administrators might not see a need to add palliative care to their list of services if the area they serve is also served by hospice care. In the Shoals, there are more than 13 hospice agencies that provide the same type of care a patient might receive in a palliative care bed at a hospital.

One possible reason for the number of providers is that, for the time being, Medicare reimbursements for palliative care are still relatively high compared with the cost of providing that care.

Helen Keller Hospital in Sheffield has operated its nonprofit hospice business since 2005.

Jeanne Maggerise, clinical director of Keller's program, said being under the umbrella of the hospital allows caregivers to offer patients a continuum of care.

"I'm a little surprised to hear about our failing grade," she said. "We are fairly saturated with hospice here, but, when you go to other areas of the state, that might not be the case."

Michelle Rupe Eubanks can be reached at 740-5745 or michelle.eubanks@TimesDaily.com.