Smilow Palliative Care Program
The Palliative Care Program at Smilow Cancer Hospital focuses on symptom management and quality of life concerns for adult patients with serious chronic progressive or terminal illnesses. We center our care on patients and families, and help them deal together with their loved ones’ physical issues such as pain, fatigue, and nausea, as well as with psycho-social issues like depression, disruption of family life, and financial concerns.
Each patient consultation includes a comprehensive review of medical records and medical history, a physical examination, and a discussion of the symptoms, goals, values, social interests, and spiritual needs of the patient and his or her family. Ongoing evaluation and follow-up care are then provided as needed.
Palliative care uses many approaches, depending on the individual patient’s symptoms, needs, and wishes. It might involve the following:
- Pain management
- Complementary techniques, including breathing exercises, massage or Reiki, acupuncture, art or music therapy
- Mental health services and coping strategies
- Relaxation techniques
- Spiritual support and guidance
- Nutritional support
- Family support
- Discharge planning
The palliative care team includes expert physicians and advanced practice providers who partner with social workers, chaplains, pharmacists, care coordinators, and other clinical staff members to offer an additional dimension of expertise. Our staff is experienced in helping patients and families manage distress in the face of serious illness, as well as at life’s end.
It’s important to note that unlike hospice care, which is meant specifically for those approaching the last stages of life—usually the final six months—palliative care can complement ongoing treatment at any stage of illness. Palliative care does not mean that active treatment to cure a disorder or prolong life will end. All care will continue through any stage or time in each patient’s illness.
Yale New Haven Hospital Bereavement Services provides care and support to families and friends to help you learn how to live life without your loved one.
Grief is a natural response to loss, but the way we grieve is unique to each person. Our experienced staff of clinical social workers can help with learning and understanding more about grief which will help with healing.
- Telephone outreach
- Monthly bereavement seminars
- Bereavement support groups
- Information and referral for bereavement resources
- Hope for the Holidays (support for coping during the holiday season)
- Annual Memorial Service (a formal service to remember your loved one, conducted in collaboration with Spiritual Care and Patient Relations)
For more information, contact:
Andrea Lucibello, LCSW
Coordinator of Bereavement Services
Outpatient Palliative Care
The Outpatient Palliative Care Clinic at Smilow Cancer Hospital uses an interdisciplinary team approach to provide an extra layer of support for both patients and their families.
These services include:
- Help with decision making
- Determining goals of care
- Pain and symptom management
- Supportive resources for life changes
- Meaning-centered individual and group programs
- Bereavement and grief support groups
- Resilience building
- Emotional coping skills
- Cognitive behavior therapy
- Creative expression
- Values and spiritual resources
- Existential concerns
- Advance directives
- Home care
- Community services
- Integrative medicine
- Smilow Pain Clinic
- Addiction medicine
Palliative Care Program Members
Jennifer Kapo, MDInternal Medicine, Hospice & Palliative CareJennifer Kapo, MD, director of Yale Cancer Center’s Palliative Care Program at Smilow Cancer Hospital, dedicates her life to helping people diagnosed with serious illnesses. Through careful listening, she provides comforting care, always keeping the individual’s life goals in mind. She enjoys being part of a team that provides the support patients and families need when experiencing a serious illness—from diagnosis through end of life. Dr. Kapo helps ease pain, suffering and stress through medical interventions and by providing access to psycho-social support, parenting help, spiritual services and financial counseling as needed (and on a case-by-case basis) because every cancer patient’s needs and experience are unique. “What we also try to do in palliative medicine is to the support the oncologist, patient and their family in having difficult conversations about the medical condition in a gentle, informative way so that patients actually feel more supported after having these conversations,” Dr. Kapo says. Research shows that patients and families desire all information—both good and bad—about their condition, says Dr. Kapo, who is also an associate professor of geriatrics at Yale School of Medicine. She makes it her mission to provide this information accurately and in such a way that families can still access what they need most during a trying time: hope.
Dmitry Kozhevnikov, DOInternal Medicine, Hospice & Palliative CareDmitry Kozhevnikov, DO, is a Yale Medicine hospice and palliative medicine doctor and the director of outpatient palliative care, Smilow Hospital Care Centers. He is passionate about empowering patients with tools to maximize their quality of life, allowing them to make the best of every day. “I enjoy providing help in managing difficult symptoms and spending time with patients and their families as they seek guidance in dealing with the many challenges that serious illness may bring,” he says. “In my work, I am constantly inspired by the immense strength, both emotional and spiritual, that patients living with serious illness display throughout their cancer journey.” It is his goal to provide medical care that closely matches patients’ values, hopes, and goals for the future. “I encourage patients to be in-tune with the things that are most important to them and to share that information with their medical providers,” Dr. Kozhevnikov says. In addition to caring for patients, he is a clinician educator who teaches medical students, residents, and fellows the importance of communication skills when working with patients who have advanced illnesses. To that end, he arranges simulated patient experiences using actors. “It’s a welcoming and safe space for physicians to learn and practice the communication skills required to care for patients with serious illness in an empathic and patient-centered way,” he says.
Laura J. Morrison, MDInternal Medicine, Hospice & Palliative Care, GeriatricsLaura J. Morrison, MD, is an internist with additional training in palliative care and geriatric medicine. “Serving as a palliative care physician is a great privilege,” she says. “I truly value traveling with patients and their families through the course of serious illness, adding extra support around physical symptoms, spiritual concerns, psychological and emotional stressors, and social challenges.” Dr. Morrison sees patients as part of the Yale Palliative Care Program with the Yale New Haven Hospital Palliative Care Consultation Service with a focus on hospitalized patients. “I enjoy providing extra support to patients facing serious illness and their families with a focus on managing symptoms, coping with illness, and aligning patient and family goals and treatment options,” she says. Dr. Morrison also directs the physician fellowship training program for hospice and palliative medicine and focuses her scholarly work on increasing palliative care, communication skills, and health care provider resilience training locally and nationally.
Elizabeth Horn Prsic, MDHospice & Palliative CareElizabeth Prsic, MD, is a medical oncologist and palliative medicine physician who specializes in the inpatient care of patients with advanced cancer. She works with an interdisciplinary team to help support patients who are facing serious illness and their caregivers. Dr. Prsic’s research interests include end-of-life care, health care utilization, symptom management, and supportive care for patients with advanced cancer. She earned her medical degree from the George Washington University School of Medicine. She completed her internal medicine internship, residency, and medical oncology fellowship at Brown University’s Warren Alpert Medical School, where she also completed a National Institutes of Health-funded research fellowship focusing on end-of-life care. She completed her hospice and palliative medicine fellowship at the University of Washington. She is an assistant professor at Yale School of Medicine, and serves as the firm chief for medical oncology and the director of Adult Inpatient Palliative Care.
Andrew Tyler Putnam, MD, BAHospice & Palliative CareAndrew Putnam, MD, practices adult and pediatric palliative medicine, caring for patients both in and out of the hospital. Dr. Putnam’s goal is “making people feel better so that they are able to be treated for their disease.” He especially enjoys forming relationships with patients to help them more successfully navigate their medical issues. “I want to help people at crucial times in their lives, to help them think of themselves as whole people—and not just as a disease,” Dr. Putnam says. The doctor-patient relationship is the key to the successful practice of medicine, not only in palliative care, but in general, Dr Putnam says. “I will always tell the truth even if it is hard to hear and hard to say,” he says, adding that it’s important for patients to understand what is happening medically, and be aware of the options available to them. Dr. Putnam was director of palliative care at Georgetown University for 11 years before coming to Yale, where he is an assistant professor of medicine and assistant clinical professor of nursing. His interests include pain and symptom management in people with severe disease including cancer, as well as physician-patient communication.
Vinay Rao, DOVinay Rao, DO (doctor of osteopathic medicine), is an internal medicine-trained palliative care physician who cares for patients at Yale New Haven Hospital and Smilow Cancer Hospital. Palliative care is a specialized kind of medical care for people living with serious illnesses. This type of care is focused on providing relief from the symptoms and stress of a serious illness, improving quality of life, working together with other doctors to provide an extra layer of support, and tailoring the care provided based on the needs of the individual person. Dr. Rao views each of his patients as a whole person, in addition to understanding the biological processes of his or her disease. He attends to the physical, psycho-emotional, spiritual, social, and functional needs of each of his patients. He also has an interdisciplinary team of other medical professionals who he works closely with to provide this comprehensive level of care. Dr. Rao has a keen interest in improving communication between patients, families, and their health care providers. He understands that each patient has a unique perspective, and each patient their own goals, hopes, and values for the care they want to receive. Dr. Rao sits with and supports each one of his patients throughout their illness journey. Dr. Rao’s research interests include improving communication, helping patients cope with prognostic uncertainty, and improving the quality of outpatient care. He is a member of the Yale New Haven Hospital Ethics Committee and the NCCN Distress Management Guidelines Institutional Review committee. He is currently an assistant professor of medicine at Yale School of Medicine.