Whole person care – population health care with heart

By Ira Byock, M.D.

thumbnail_9During her serious illness, Alesha made new friends, repaired family relationships, and got married. While hospitalized for a life-threatening medical condition, she and her loved ones reclaimed a rich part of their lives.

These healing experiences are increasingly common within Providence St. Joseph Health ministries and practices, under the auspices of whole person care and in harmony with population health programs.

The Providence Institute for Human Caring seeks to create a culture of whole person care by bringing the tenets of palliative care across all care settings to all patients and their loved ones. 

In focusing on the values, preferences and priorities of whole persons, rather than just diagnoses and treatments, we are concerned about how people feel – physically, emotionally and spiritually – about their level of function and independence, and about the well-being of those they love.

Whole person care ripples out from the focus on the individual, and touches families and communities. While we think of medical care as being encounter-based, it actually travels in time to the future. To minimize grief, say, when someone has end-stage liver disease or cancer, we tend to the emotional, spiritual and psychological well-being of the person in our care and their loved ones. We’re applying a healing balm that transcends a single medical episode.

By focusing on the whole person and the well-being of their loved ones, we can help replace unresolved grief with a sense of accomplishment and satisfaction.

In caring for people such as Alesha as a whole person, we can bring the best medical science to bear for her medical condition. But she has feelings and friends and people who matter to her. She lives in a community. And if she gets medically worse, her quality of life will live within her loved ones for a long time to come.

Whole person care means giving Alesha the best care we possibly can. And it also means her family gets care in their grief when she does leave this life.

In making it easy to have conversations about a person’s goals of care, we’re making sure health care is highly personalized, and not applying a one-size-fits-all model. We’re making sure that people’s cultural background, ethnic and religious values, and even personal idiosyncrasies are honored within a truly personalized style of care.

Whole person care and population health are concerned about the well-being of families and communities – about primary prevention (of injury and illness) and secondary prevention – of complications of those who are already ill – as well as adverse impacts of illness on family caregivers and close relatives.

Both are concerned about social determinants of health – their housing, diet, exercise, environmental quality, how they get from place to place – because all of these also matter to individual and family well-being.

Our patients don’t live in doctor’s offices or hospitals. They live in a community. So, in taking care of whole persons, we are taking care of people in the context of their families and their communities.