A primary care physician finds rewards with hospice care

Jorge Alfonso, MD, a primary care physician at Yarmouth Primary Care, has spent years caring for patients and treating them for various medical challenges and diseases. Along the way, he began educating and supporting patients about the end of life, as they faced their chronic disease progression. He now finds one of his greatest rewards in providing hospice care as the medical director of Visiting Nurse Association (VNA) of Cape Cod Hospice & Palliative Care.

“In my primary care practice, I began noticing that, as some of my patients approached the end of their life with their chronic diseases, there weren’t many resources to help them gain an understanding of what was going on,” he said. “As time went on, I became more involved educating my patients about end-of-life care and educating their families, which I found to be just as important.”

His transition into the hospice care arena began in 2012. He became the medical director of the VNA of Cape Cod Hospice and Palliative Care division in 2019, when Cape Cod Healthcare acquired the McCarthy Care Center in Sandwich.

Hospice care is a side of medicine that many people are never exposed to, said Dr. Alfonso. In general practice, primary care providers see their patients every three to six months to follow up with their chronic disease.

“As many of my patients’ conditions worsened with the progress of their disease, I began to see them every two to four weeks and what I found is, the more frequently I saw them, talked with them and educated them about the worsening progression of their disease, the more they began to understand what they would be facing with the end of their life. That’s when I started getting more involved with this type of care and here I am with hospice,” Dr. Alfonso said. “It is work I really enjoy, and it is also very humbling.”

Transition to Hospice Care

The patients with chronic diseases who benefit from palliative and hospice services include those with ALS (amyotrophic lateral sclerosis) a progressive neurodegenerative disease, MS (multiple sclerosis), a chronic neurological disorder, Parkinson’s disease, an age-related degenerative brain condition, and different types of cancer such metastatic cancer, lung and pancreatic, said Dr Alfonso.

As chronic disease progresses, patients may choose palliative care which can improve quality of life when end of life is not imminent, and they can also continue their treatments, said Dr. Alfonso. Once their specialists begin telling them they have done everything they could for them and they should consider hospice care, they can be transitioned to end-of-life care when we provide comfort measures and support them through this time.

Greatest Rewards

“The greatest reward is knowing that I’ve done the best I can to try to transition patients through end of life with peace and tranquility, not only for the patient but also their family,” said Dr. Alfonso. “Many people may think that it is depressing work, but it is truly a blessing to help a patient transition to the other state of life, which is death and beyond.”

Further information about the VNA of Cape Cod Hospice and Palliative Care is available by calling 508-957-7400.