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Palliative Care – Llorens Pembrook, MD Video

Opening screen with title “American Health Journal” and swirling graphics in motion over blurred images of physicians.

[Serious music]

Announcer (V.O.): Palliative care is a multi-disciplinary approach delivering specialized medical care for patients with life threatening illnesses. Dr. Llorens Pembrook at Valley Presbyterian Hospital in the San Fernando Valley compares hospice care and palliative care.

V.O. visual: Elderly woman lying in a hospital bed with family members around her talking; Close-up of Valley Presbyterian Hospital sign on exterior of building; Pembrook walking up hospital hallway toward and past the camera.

Llorens Pembrook, M.D.: Palliative care started off as a continuum of hospice care. Hospice care is taking care of patients who are essentially…

Visual: Close-up of Pembrook, wearing a shirt, tie and white coat, is being interviewed in a studio with a bright blue and black background. He is introduced with the title “Llorens Pembrook, MD – Valley Presbyterian Hospital” in the lower-third.

Pembrook (V.O.): …end of life. Palliative care came along that looked at the symptoms of patients prior to that time.

V.O. visuals: Family praying with a minister in the hospital waiting room; young woman visiting an elderly woman in the hospital next to her bed;

Pembrook: And look across specialties, internists, hospitalists, oncologists, we found out that patients were not getting the quality, high level of care…

Pembrook (V.O.): …the support system, like a social care that they deserve, and pain management primarily. So the palliative care part of it is the…

V.O. visuals: Pembrook at the front desk of the unit looking at a computer monitor; different angle over his shoulder of computer screen as he types on the keyboard.

Pembrook: …subspecialty, working with the acute care physicians as well as the oncologists, both in and out of the hospital, and our job is primarily symptom control and support for the families.

Pembrook (V.O.): Dr. Pembrook examines the development of hospice and palliative care.

V.O. visuals: Blurred video of a female family member walking into a hospital room toward a patient in the bed.

Pembrook: Hospice care was developed in the United States back in 1982. So, it’s been here for a long time. Palliative care has only been for approximately ten years where you call in subspecialty physicians like myself to take care of those patients before (sweeping gesture with hand across screen) they die. So, it’s a continuum of taking care of the patients who are extremely ill, no curable medical problems, and then they pass that point (another sweep of hand) and they go into hospice care.

Announcer (V.O.): Dr. Pembrook discusses the support system that makes up the palliative care team.

V.O. visual: Pembrook talking with a female nurse in the hospital.

Pembrook: So the support consists of a core group of a physician who specializes in palliative care, a nurse who specializes in palliative care, a social worker, and then, a spiritual person, non-denominational spiritual person. Obviously what the spiritual person does is tremendous support for family members across the religious spectrum. The physician is in charge of the team.

Pembrook (V.O.): The nurse is to spearhead, so to speak. She or he will go out there and identify the patients who are appropriate for palliative care or hospice care, and will begin the introduction to the family and is extremely important with the ongoing supportive care of family members.

V.O. visuals: Female nurse talking with a elderly male family member in the waiting area; close-up of nurse giving medication to the male, various angles.

Pembrook: And the social worker is again invaluable because he or she will actually set up…

Pembrook (V.O.): …the necessary support systems that the patient needs to have at home which will include a bed in some cases, a skilled person to go out and help them at home, everything that needs to occur at home. Essentially what a hospital bed in a room looks like, that person will schedule to have that done at home.

V.O. visual: A nurse walks into the home bedroom of an elderly male patient who is propped up in a hospital bed and gives him an extra pillow; the nurse rubs the arm of the patient; another angle of the nurse smiling at the patient.

Announcer (V.O.): Dr. Pembrook emphasizes the importance for family members to discuss these crucial decisions.

V.O. visual: A group of women and men who look sad sit in a support circle talking.

Pembrook (V.O.): In my opinion the most important conversation to be brought up with a family member is to address what you would want to have done toward the end of your life. Do you want to have all of this technology we put you through? Do you want to talk about death? Do you want to tell me what you want me to do if you end up in a hospital? Do you ever want to be on life support? Do you want to go to a skilled nursing unit? Just bring up the topic. The majority of time I’ve seen…

V.O. visuals: The support group continues talking; another angle focusing on a middle-aged man and woman as a male social worker, holding a paper and pen, talks to them; another angle of the couple over the shoulder of two other members; wider shot of the circle as one of the women wipes away tears.

Pembrook: …is to make sure that mom doesn’t suffer at end of life. That is the most important word that I hear from all family members…

Pembrook (V.O.): …and the second one is dignity at end of life. It’s a matter of supporting them from a symptoms standpoint and essentially helping them through the dying process. Sometimes it’s as easy…

V.O. visuals: Close-up of a middle-aged man and woman looking over paperwork with a social worker; a man, woman and teenaged daughter sit in their home talking with a social worker.

Pembrook: …as holding their hands and listening to them and other times it’s being there when they do not have the support system from their family members and we are like the extended family to them at that time.

Announcer (V.O.): Dr. Pembrook reveals his satisfaction in assisting patients and families at their critical time.

V.O. visual: Pembrook talking with a nurse sitting behind the desk in one of the hospital’s units.

Pembrook: When families come up to you and they say, ‘I’m glad he didn’t suffer toward the end of life, he was treated in a dignified manner, everything he wanted was attended to at the end of life,’ it’s tremendously satisfying. I think I’m in, for me, the most satisfying subspecialty that I could have ever, it could ever, just morphed into over a period of time. I love what I do.