Case Study: Finding Balance: How Integrated Palliative Care Improved Quality of Life While Reducing Hospital Stays

THE WAKE-UP CALL

Emily Matthews, a 62-year-old elementary school principal diagnosed with stage III ovarian cancer, faced debilitating symptoms that repeatedly sent her to the emergency room despite aggressive treatment. Within three months of integrating specialized palliative care alongside her oncology treatment, Emily experienced a 68% reduction in hospital admissions while reporting a 7-point improvement on the 10-point quality of life assessment scale.

"Palliative care didn't just manage my symptoms—it gave me my life back. I went from constantly worrying about the next crisis to having the energy to attend my grandson's baseball games again," says Emily.

CRISIS POINT: WHEN UNMANAGED SYMPTOMS THREATEN TREATMENT CONTINUITY

Emily's journey with ovarian cancer began in September 2024, with her treatment plan including surgery followed by aggressive chemotherapy at Northeast Regional Medical Center. Despite the oncology team's expertise in treating her cancer, Emily struggled with severe symptoms that significantly impacted her daily functioning.

In the three months following her diagnosis, Emily visited the emergency department seven times and was hospitalized three times for complications including:

• Uncontrolled nausea and vomiting leading to dehydration

• Severe pain rated consistently at 8-9 out of 10

• Debilitating fatigue preventing basic self-care

• Increasing anxiety and depression affecting sleep and appetite

Her husband Mark recalls the difficult period: "We were constantly in crisis mode. Emily couldn't keep food down, couldn't sleep through the night because of pain, and started wondering if the treatment was worse than the disease. We were both at our breaking point."

The frequent hospitalizations also disrupted Emily's chemotherapy schedule, potentially compromising treatment efficacy. Her oncologist, Dr. Samantha Wei, noted that Emily's quality of life score had dropped to a concerning 3 out of 10, and she had lost 18% of her body weight in just three months.

"Emily was determined to fight her cancer, but her body was fighting the treatment. We needed a different approach to help her complete the full course of therapy while maintaining her strength and dignity," explained Dr. Wei.

THE BLUEPRINT: FROM CRISIS MANAGEMENT TO COMPREHENSIVE CARE

In December 2024, Dr. Wei recommended integrating specialized palliative care services with Emily's ongoing oncology treatment. The palliative care team, led by Dr. James Morales, conducted a comprehensive assessment that examined not just Emily's physical symptoms but also her emotional, social, and spiritual needs.

The integrated care approach included:

1. Personalized Symptom Management Protocol:

   
   

   • Development of a preemptive anti-nausea medication schedule rather than treating symptoms after onset

   • Implementation of a multimodal pain management plan combining pharmacological and non-pharmacological approaches

   • Creation of a fatigue management strategy with planned rest periods and energy conservation techniques

     
     

2. Coordinated Communication System:

   
   

   • Establishment of weekly team meetings between oncology and palliative care providers

   • Implementation of a shared electronic documentation system for real-time updates

   • Development of clear escalation protocols for symptom management

     
     

3. Patient Empowerment Program:

   
   

   • Education for Emily and Mark on early symptom recognition

   • Training on home-based interventions for common side effects

   • Provision of 24/7 telehealth access to palliative care specialists

     
     

4. Family Support Integration:

   
   

   • Regular family meetings to address caregiver burden

   • Connection to community resources and support groups

   • Respite care arrangements to prevent caregiver burnout

     
     

"What impressed me most was how the palliative care team didn't just throw medications at my symptoms," Emily notes. "They took the time to understand how each symptom affected my life and what mattered most to me. When I mentioned missing my grandson's games, they specifically tailored my fatigue management plan around those events."

The implementation faced initial challenges, particularly in coordinating care between departments with different documentation systems. The team overcame this by implementing weekly in-person rounds and developing a shared care dashboard specifically for patients receiving integrated care.

THE TRANSFORMATION: MEASURING SUCCESS

Three months after implementing the integrated palliative care approach, Emily's health outcomes showed remarkable improvement:

Metric	Before Palliative Care	After Palliative Care	Change
Emergency Department Visits	7 in 3 months	1 in 3 months	-86%
Hospitalizations	3 in 3 months	0 in 3 months	-100%
Pain Scores (0-10)	Average 8.2	Average 3.1	-62%
Quality of Life Score (0-10)	3/10	8/10	+166%
Chemotherapy Sessions Completed	67% of scheduled	100% of scheduled	+49%
Weight	18% loss	7% regained	+9%

Beyond these quantifiable metrics, qualitative improvements included:

• Emily's return to limited work responsibilities (4 hours weekly, remotely)

• Attendance at five family events, including her grandson's championship game

• Improved sleep quality from 2-3 hours per night to 6-7 hours

• Reduced caregiver burden, with Mark reporting his stress levels decreasing from 9/10 to 4/10

"The difference was night and day," says Mark. "Instead of constantly reacting to emergencies, we had a plan for everything. The 24/7 access to the palliative care team meant small issues never escalated into crises. I got my wife back, and I got some of my life back too."

Dr. Wei observed that the improved symptom management had systemic benefits: "With Emily feeling better day-to-day, she was stronger for treatments, had fewer delays, and showed better tolerance to the chemotherapy. This integrated approach didn't just improve her quality of life—it potentially improved her cancer care outcomes as well."

WISDOM GAINED: KEY INSIGHTS

This case highlighted several critical insights about integrating palliative care with active treatment:

1. Early Integration Creates Preventive Opportunities Rather than waiting until symptoms become unmanageable, early palliative care assessment allowed for preventive interventions. Proactive symptom management prevented the cascade of complications that had previously led to hospitalizations.

   
   

2. Coordination Requires Structured Communication Systems The success of the integrated approach depended heavily on structured communication between specialties. Weekly team meetings and shared documentation were not optional extras but essential components of effective care coordination.

   
   

3. Patient Education Transforms Passive Recipients into Active Participants By educating Emily and Mark about symptom management strategies and early warning signs, the team extended their reach beyond clinical settings. This empowerment approach converted what could have been emergency situations into manageable home interventions.

   
   

4. Family Support Directly Impacts Patient Outcomes Addressing caregiver burden wasn't just compassionate—it was clinically necessary. As Mark's stress decreased, his ability to support Emily increased, creating a positive feedback loop that enhanced her recovery between treatments.

   
   

5. Quality of Life Metrics Deserve Equal Priority With Treatment Metrics Tracking Emily's quality of life as rigorously as her treatment compliance revealed important correlations between feeling better and healing better. When quality of life improved, treatment adherence and efficacy typically followed.

   
   

"What we learned from Emily's case has changed our approach to all cancer patients with complex symptoms," notes Dr. Morales. "We now initiate palliative care consultations at diagnosis rather than waiting for symptom crises, and we've seen similar improvements across our patient population."