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Palliative care services are now available to patients at Providence Medical Center. Palliative care is a medical specialty in which professionals provide interdisciplinary care focused on helping patients with chronic and/or terminal illness to improve their quality of life while maintaining dignity, and symptom management.

Twyla “Arielle” Johnson, FNP, MSN, nurse practitioner, with Appl Orchard Palliative, is a palliative care nurse transition navigator who can:
• Assist patients and family members with discussions of their goals of care and to assist with the navigation of implementing
their wishes into their plan of care.
• Meet patients who have frequent re-hospitalizations, often due to a chronic disease and educate them about palliative care
in addition to community services.
• Communicate with the care team and Case Managers to ensure continuity of care.
• Identify and address obstacles that are keeping patients from being successful at home or in the community where they

In partnership with the patient’s primary care provider and/or hospitalist, Arielle can initiate goals of care discussions, offer support, and assist with patients’ wishes regarding code status.
Overall goals with the program are to:
• Assist in treatment planing to manage symptoms often associated with chronic disease processes and rehospitalizations.
• Review medications and treatment.
• Improve/maintain quality and dignity of life.
• Assist patients and families with after-discharge plan of care.
• Assisting in challenging end-of-life issues and family dynamics.

After a patient is referred to the Palliative Care team by the attending physician, Arielle meets with the patient and family members to discuss the patient’s condition and treatment goals. She spends time with the patient and family, answering questions, alleviating fears, and ensuring families understand everything that is involved in the patient’s overall health and plan of care for their loved ones.

The goal is to have palliative care specialists brought in early in the patient’s treatment process, so the patient is comfortable and has a good quality of life. This can also assist with identifying factors that may hinder or delay discharge.
Arielle has been a nurse for 13 years and an FNP-C for four years. She has a diverse background in nursing including several areas of acute care, Oncology, Hospice, Family Medicine, and Long-Term Care Management.