Palliative & Therapeutic Harmonization Clinic (PATH clinic)
The PATH Clinic provides assessment and consultation services to help older individuals and their families understand their true health status and outlook for the future.
The goal of the PATH Clinic is to help patients and families learn how to make health care decisions that support patients’ overall health and quality of life.
Location and Contact Information
Who is the PATH for?
The PATH Clinic is for individuals over the age of 65 with multiple chronic health problems including heart failure, kidney disease, dementia and frailty. In most cases, the clinic sees a family member along with the patient.
How do I access this service?
The PATH outpatient clinic at the Geriatric Ambulatory Care Clinic in the Veterans’ Memorial Building is open to clients and their caregivers who:
- have advanced or progressive illnesses;
- have had multiple hospital admissions or uncontrolled symptoms;
- have experienced a progressive decline in mobility, function, or cognition;
- have a dedicated caregiver/family member; and/or
- are interested in receiving more information about their anticipated future health and options for integrating a palliative approach into their existing therapies.
The PATH may not be for everyone. Clients or caregivers who do not wish to receive information about current and future health, or who do not wish to contemplate future health care decisions should not be referred to PATH.
- Referral Form (.pdf)
Why is the PATH important?
As people accumulate health problems, they become frail. This means they have more difficulty recovering from illnesses and injuries than people who are healthier. In fact, some treatments could worsen their overall health status and quality of life. The PATH Clinic helps patients and families understand these issues in relation to their own health status and learn to ask the right questions as new health problems emerge. This way, they can realistically consider the risks and benefits of potential treatments and make wise decisions.
What can I expect from the program?
The PATH process involves 3 clinic visits with the following goals:
Visit 1: Comprehensive assessment of physical, psychological, and social health
Visit 2: Exchange of expectations and information between client, caregiver and health professional
Visit 3: Learning new skills to help with future health decisions
- Physicians at the PATH Clinic conduct a comprehensive assessment of each patient’s physical, mental and social wellbeing. This helps them understand the patient’s complete health picture and how they are likely to respond to potential treatments in the future
- The PATH physicians share the results of the assessment with the patient and family. They answer questions and listen carefully to the concerns and wishes of patients and families. Their goal is to ensure that all parties understand the current situation and what to expect
- PATH physicians work with patients and families to make immediate health care decisions and to chart a course for the kinds of decisions that will need to be made in the future. They inform the patient’s family physician and other relevant health professionals of any decisions that have been made
- At the end of the process, PATH physicians provide patients and families with the knowledge and resources to help them know what questions to ask, and what to consider, when faced with a new health problem. This empowers patients and families to make health care decisions that preserve quality of life and promote dignity
Patients and families have time to reflect on what they are learning after each process and are free to contact the PATH Clinic at any time with questions or concerns.
What are the principles of the program?
The PATH Clinic follows four key principles in its work with patients and families:
- Knowledge is power
- People want and deserve complete and accurate information about their health status and how their health conditions will affect them in the future. We believe that when people truly understand their overall health picture, they will make the best decisions for themselves
- Focus on the big picture
- Doctors must look at what’s best for the overall health of patients with multiple health problems rather than trying to treat each separate illness. Frail older people with many serious chronic illnesses are less likely to respond to treatments. In addition, the treatment for one illness could make another illness worse and cause more overall harm. We believe that doctors must consider how all of a person’s illnesses and potential treatments interact, so they recommend only those steps that will help to improve or maintain overall health
- Carefully explore the risks and benefits
- The best health care decisions are made after full consideration of the long term risks and benefits. Patients and families can only make health care decisions that are right for them if they grasp the true nature of how a situation will unfold. While bad news is hard for doctors to give, and many do not want to take away hope, they must provide complete and honest information about what the future holds. We believe that patients and families can only plan appropriately if they know how severe an illness is, how it will progress, and how it may shorten life
- Ask the right questions
- We believe that taking an organized approach to decisions making, we can help patients and their families learn how to make more carefully considered decisions about what treatments they may or may not want to accept. We will provide you with questions to ask that will allow you to weight the risks and benefits of potential treatments. Although we cannot predict every future decision that you may face, if you choose to join us on the PATH, we will walk you through a program that will teach you the skills you need to make decisions for yourself or your family member now and in the future