Palliative Medicine:
AMOREM provides an extra layer of support
When Bob* suffered a massive stroke at age 80, his hospitalization was lengthy and complicated, an experience that was deeply traumatic for both Bob and his family. Bob’s daughter-in-law, who works at a local cancer center, had firsthand knowledge of the benefits of palliative medicine and reached out to AMOREM requesting an evaluation to determine whether hospice or palliative medicine was the most appropriate level of support. After evaluation, AMOREM’s access and enrollment team determined that Bob was more appropriate for palliative medicine and partnered with his primary care provider to initiate a formal referral.
What is palliative medicine?
Palliative medicine is a consultative medical specialty that provides an extra layer of support for anyone living with a serious illness.
The goal is:
- to optimize quality of life
- reduce avoidable hospitalizations and
- empower patients and families as they navigate complex medical conditions
Care is provided by a medical doctor or nurse practitioner.
From the beginning, Bob and his family were clear in their goal: to remain at home for as long as it was safe and feasible. However, following the hospitalization, Bob experienced persistent psychological distress, including nightmares that lasted for months and ongoing agitation when discussing the hospital experience. This history significantly shaped their preferences to avoid future hospitalizations whenever possible.
AMOREM’s palliative medicine team became a central support in helping Bob stabilize and remain at home. The team coordinated durable medical equipment and initiated home health physical and occupational therapy when warranted to address mobility challenges from the partial paralysis from his stroke. Over time, these efforts improved his mobility and ability to safely navigate his home with assistance.
Today, Bob is considered home limited, requiring significant assistance from his wife for outings and transportation, but demonstrating improved functional status compared to the immediate post-stroke period. Since AMOREM’s palliative medicine program joined his care team three years ago, Bob has had no hospitalizations and only two falls over the three years, both associated with attempts to mobilize outside of recommended safety precautions.
In addition to physical challenges, Bob developed neurocognitive and behavioral symptoms consistent with vascular dementia, including sundowning, anxiety and agitation. AMOREM’s palliative medicine team helped manage these symptoms, adjusting medications to achieve better response, which resulted in improved symptom control and reduced caregiver strain.
In May 2025, Bob experienced another significant clinical turning point with a diagnosis of metastatic squamous cell carcinoma. At that time AMOREM’s palliative medicine team facilitated a comprehensive goals-of-care discussion, outlining the risks and benefits of aggressive treatment in the context of his overall health, including cerebrovascular disease and cardiac conditions.
Because of the established, longitudinal relationship with AMOREM’s palliative medicine team, Bob and his family were able to engage in a thoughtful, values-based decision-making process. Bob ultimately chose to pursue ongoing immunotherapy while also establishing clear limits of care, electing Do Not Resuscitate (DNR) status and completing a MOST form to ensure his wishes are clearly documented.
Bob continues to receive immunotherapy through his oncology team with documented improvement in metastatic disease and stable clinical status. Palliative medicine remains actively involved, providing ongoing symptom management, monitoring for functional decline and supporting both Bob and his family as needs evolve.
Bob’s story is a great example of the real impact of palliative medicine, supporting patients to remain at home, improving quality of life and guiding families through complex decisions with confidence and dignity. AMOREM’s palliative medicine team not only improved symptom management and quality of life, but also strengthened the relationship and trust between the care team, the patient and his family. Those connections are what make truly meaningful, person-centered care possible.
AMOREM, formerly Burke Hospice and Palliative Care and Caldwell Hospice and Palliative Care, is proud to be your local, nonprofit hospice and palliative medicine provider with nearly 45 years of experience providing the highest quality care possible. AMOREM has local care teams that provide hospice and palliative medicine services wherever a patient calls home, as well as patient care units located in Valdese, Hudson, Lenoir and soon in Boone to serve the needs of patients and families in the community.
To learn more about AMOREM services or to make a referral, visit www.amoremsupport.org or call 828.754.0101 to speak with a local team member.
*Bob is a fictitious name for an actual patient.
