Help and Support for People Facing a Serious Illness

Gilchrist is a name that’s well known in Maryland, but W. Anthony Riley, MD, chief medical officer at Gilchrist, thinks that many Marylanders don’t know about the full range of services that the organization provides for patients and their families.

“When people hear the Gilchrist name, the first thing that comes to mind is hospice care,” he explained. “But we offer a much broader range of services for patients who are facing a serious illness and their families, from care and support for frail geriatric patients to integrative and palliative medicine for people at any stage of a serious illness.”

Dr. Riley also talked with Mary Beth Marsden about the importance of making an advance care plan well before you’re facing an illness, an issue that’s unfortunately become more pressing during the COVID-19 pandemic. An advance care plan is a tool that lets your physicians and family members know what types of care and support you want if you’re seriously ill or living with a worsening chronic condition for which there is no cure, like lung disease or heart failure.

“If you’re healthy, making medical decisions is simpler. But when you’re facing an illness from which you may not recover, the decisions become more complicated,” Dr. Riley said. “All medical interventions come with risks. When you’re frail or have an illness that cannot be cured, the risks and burdens of some treatments may outweigh the benefits. An advanced care plan allows you to make important decisions about your care before you’re in the midst of a medical crisis.”

An advance care plan focuses on patient-centered medical decision making and ensures that your care will be in line with your values and wishes, even if you are not able to speak for yourself. There are three parts to the process—choosing a healthcare agent who can make decisions on your behalf if you are not able to, deciding what types of care you do and do not want and when these decisions should be applied to your care, and putting your plan on paper. After you’ve created your plan, you’ll need to talk with your doctor to create an advance directive and medical orders of life sustaining treatment (MOLST), the documents needed to carry out the wishes you express in your advance care plan.

Dr. Riley noted that it’s often helpful to include family members in the process of creating your plan because going through this process together helps avoid friction and conflict amongst family members when someone is seriously ill.

“Each person approaches this process differently,” he added. “We follow the patient’s lead, asking, ‘How do you prefer to talk about this? How much or little information do you want? Who else should be involved in the process?’ The patient lays the ground rules and we provide advice and support.”