New Program Aims To Train More End-Of-Life Caregivers


Hospice care
J. Pat Carter/AP

Joe Takach comforts his friend Lillian Landry, as she spends her last days in the hospice wing of a hospital in Oakland Park, Fla., in 2009.

One year into its medical fellowship program for end of life care, partners Nathan Adelson Hospice and Touro University are claiming success.

The nonprofit hospice even hired one of the doctors from its first program.

Now the program is welcoming three new fellows who for a year will provide end-of-life care to as many as 400 patients served by the hospice.

Dr. Catrisha Cabanilla Del-Mundo was hired by Nathan Adelson Hospice after recently finishing her fellowship. She told KNPR's State of Nevada that there is a lot more to hospice care than many people think.

“There is more science behind it,” she said.

Dr. Cabanilla Del-Mundo said she as a very different view of life and death since working in hospice and palliative care than most people picture.  

“I’ve learned that when you communicate with patients that their life expectancy may not be as long as you thought, or as we all thought, it doesn’t exactly bring anxiety like you would think," she said. "It brings comfort. They know their time is short so they are able to prioritize what they want to accomplish in the last days.”

In hospice care, doctors and nurses work to manage a patient's pain, perhaps their anxiety or depression all with the focus on quality of life, Kathryn Bonello with Nathan Adelson Hospice said.

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"Hospice is focused on taking care of patients as they are going through a terminal illness." she said, "So our purpose is to make sure that their symptoms are managed, that their pain is under control." 

There is also a misconception that hospice is a place a person goes, which is not the case. Bonello said in reality it is a type of specialized care that usually takes place at home, where ever that home is located.

Another part of this type of care that people don't often understand is palliative care. 

Palliative care is the management of symptoms of people with advanced illnesses who are not facing the end of their life in six months or less, which is when hospice care takes over.

Both Cabanilla Del-Mundo and Bonello agree that although most of us don't want to talk about end-of-life issues with our loved ones, it is important to have that discussion early, instead of feeling guilty about not knowing what they would want in their final days.

“I always say it’s never too soon to talk about hospice,” Bonello said. Bonello said people need to have living wills and advance directives in case they are unable to communicate what they want. 

Cabanilla Del-Mundo said that doctors who specialize in treating a disease clearly understand what the end stages of that disease is going to be like and talking to their patients about that stage is important. 

“End of life is not something people want to talk about and when it comes up it's because it's kind of forced,” she said.

Like most medical specialties in Southern Nevada, hospice and palliative care are suffering from a shortage of physicians, which this fellowship aims to address. 


National Hospice and Palliative Care Organization

Nathan Adelson Hospice


Dr. Catrisha Cabanilla Del-Mundo, Nathan Adelson Hospice, former Hospice and Palliative Medicine Fellow; Kathryn Bonello, senior director of business development, Nathan Adelson Hospice

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