When Dr. Sandra Sanchez-Reilly was 11 years old, her grandmother fell while the two were on a walk and died in her arms. The accident inspired Sanchez-Reilly to invest more than two decades in providing end-of-life care to older adults.
An associate professor of geriatrics and palliative care at UT Health San Antonio, Sanchez-Reilly started the medical school’s palliative care program in 2003, which provides specialized medical care for people with disabilities and serious illness. The goal is to improve the quality of life for both patient and family by treating emotional, social, practical, and spiritual problems that accompany illness.
Sanchez-Reilly is being inducted into the San Antonio Women’s Hall of Fame on March 23 for service to the community extending beyond her medical career. On Wednesday mornings at 6 a.m., Sanchez-Reilly can be found at St. Matthew Catholic School, where she teaches STEM-based lessons to middle school students. She is also a Girl Scout troop leader.
In an interview with the Rivard Report, Sanchez-Reilly discusses end-of-life medical treatment, how it has evolved, and what still needs to be done to ensure quality care for aging adults.
Rivard Report: You describe providing end-of-life care as a mission, rather than a profession. Why?
Dr. Sandra Sanchez-Reilly: End-of-life medical care is not just about treating a person’s physical symptoms. It is treating their emotional, spiritual, and social health as well. We have an interdisciplinary team of care providers – including social workers, nurses, and pharmacists – who work together, taking a holistic approach to improving a person’s quality of life. Our job is to relieve suffering, and to be there when the person’s time comes. It is very important time. We work together to provide a good quality of life overall and work hard to do the right thing for every person at this moment in their journey.
We have helped people bring a horse into the hospital so a veteran could say goodbye. We brought someone’s wife in from Mexico to say goodbye to her husband who was dying. We deal with foreign embassies, consulates, and even jails; we do whatever it takes to help our patients find closure. I am so honored to do what I do. It is a mission.
RR: For many people, death can be a very uncomfortable topic of conversation. Do you find that people avoid talking about death, and if so, how might that impact their medical treatment as they near the end of their life?
SSR: In American culture, there is definitely avoidance when it comes to talking about death; but in general, people come to embrace it at some point. Geriatric and palliative care physicians often help people navigate through difficult conversations, and help families make decisions and answer questions they previously never considered because talking about death was avoided. Once people realize that death is a natural part of life, they may reconsider treatment approaches and choose a more or less aggressive approach, or make a care plan that allows for more time at home and less in a hospital.
RR: What advances in research and treatment have improved end-of-life care, and what work still needs to be done?
SSR: End-of-life medical care has a lot to do with preserving a person’s ability to function; in spite of so much research, we haven’t gotten far on that. The medical community needs to continue to look at aging and older adults as a subspecialty in order to find ways to decrease hospitalizations, keep them out of emergency rooms, and avoid disease. If we can help people stay healthy at home, we are improving their quality of life. We also need to continue to improve communication techniques to be able to help families have conversations about end-of-life care. We are taking care of very disabled, frail, and terminally ill patients, and also their families. The care we provide impacts an entire unit. So just as much as we need to work on helping people control their systems and functioning through different medications and treatments, we need to work on how to care for the family through this precious moment.
RR: What can a person do today that will help improve his or her health later in life?
SSR: Keeping healthy is very important as one ages, and that includes more than just diet and exercise. In addition to following the advice of your doctor for physical health, it is important for people to maintain social connections and strive for healthy relationships with family and friends. They also need to take care of their spiritual needs. You have some people at age 75 who are functioning very well and driving, and you have some people who are 60 and they are in a wheelchair. It’s not about age, it’s about function and quality of life. Maintaining holistic health will improve a person’s life later on. You also always want to make sure you keep your voice to make sure that people know your wishes on how you want to proceed with your medical care. No matter what, keep your voice.