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(Reprinted with permission from The Times Herald-Record — March 24, 2015 edition)

Arpine good-page0001-USEBy Beth Kalet
For the Times Herald-Record

There’s a lot more to someone with chronic illness than his symptoms. Of course, patients know this; families know this. Now medicine is stepping up with an inclusive program — palliative care — that stitches together the many aspects of care, and reaches beyond pills and treatments.

As chronically ill people shuttle from specialist to specialist, there is often a disconnect. Doctors may work in a vacuum. One medication may have a debilitating side effect that exacerbates another condition. This is where palliative care fits into the picture. It’s an individualized approach to helping patients cope with all their concerns — from medical to emotional — that goes beyond the focus most often employed by traditional medicine.

Palliative care is both a philosophy of care and an organized system of medical care, according to the Hospice and Palliative Care Association of New York State. Palliative care has been recognized by the American Board of Medical Specialties since 2006, as a way of helping chronically ill people manage their lives.

And it is now being offered by Middletown Medical, under the direction of Dr. Arpine Saribekyan, a board-certified family medicine physician who has been fellowship trained in palliative care. Saribekyan is described by the team at Middletown Medical as bringing to this role “the utmost in compassion to caring for chronically ill patients.” That’s evident, too, in conversation as she explains the value and nuance of this program that takes a team approach to caring for the entirety of each patient’s needs.

Palliative care, Saribekyan said, is “all about support … to be sure that a patient is doing well heading into these complex medical problems.” The range of concerns under the palliative care umbrella “not only address physical problems but also emotional, psychological, spiritual, social … a more holistic approach.”

Palliative care services may be right for someone diagnosed with cancer, with COPD, with dementia or another illness; it may be for someone with a curable disease. The overriding factor is that palliative care brings together the different specialists who work separately with a patient. “Sometimes all different doctors are doing it by themselves, and there is nobody looking at all of it to see what is going on. Are we doing the right job for the patient? And also the family? Family is very important for the palliative medicine doctor,” Saribekyan said.

Because palliative care aims to improve a person’s quality of life, it includes treatments that are designed to cure, along with those meant to alleviate pain, But it’s not only about medicine, Saribekyan stressed.

Looking at the whole patient, the palliative care team may recommend physical therapy or even deep breathing techniques or medicines to address physical symptoms such as pain, fatigue, insomnia or nausea. They may review what can be done when the side effects from multiple medications “work against each other.” They may guide patients and families to find help with anxiety or depression.

Given this overriding mandate to make the patient and her needs paramount means that the palliative care approach can offer a kind of relief often missing for patients with serious illness. Palliative care is not hospice. Now well-known, hospice helps patients and families deal with end-of-life concerns, making “death with dignity” possible. But palliative care is for those living with chronic illness. It may be brought to bear at any stage of an illness.

Practically speaking, a case manager can schedule a variety of tests and treatments conveniently in one location and often on the same day, Saribekyan said, “because Middletown Medical is a multi-specialty facility, that can provide care in the same building,” which makes life easier.

Most insurance plans, including Medicare and Medicaid, cover all or part of this program, according to Middletown Medical. For more on Middletown Medical’s palliative care services, visit or call 342-4774.

(Pictured:  Palliative care is all about support; to be sure that a patient is doing well heading into these complex medical problems, according to Dr. Arpine Saribekyan, shown talking with patient Ralph Marsicano at Middletown Medical.  ELAINE A. RUXTON/TIMES HERALD-RECORD)

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