Kidney Palliative Care
Improving quality of life

Palliative care is specialized care for people with serious illnesses that focuses on minimizing pain, symptoms and stress. The goal is to improve quality of life, and that is done by treating the whole person and not just the illness, by addressing the emotional, spiritual and psychological sides of disease.

“What matters most to patients is how to live well with the optimum quality of life,” says Dr. Dan Lam, “and that varies from patient to patient.”

Our interdisciplinary palliative care team from left: social worker Jennifer Christophel Lichti, nephrologist Dr. Dan Lam and nurse Megan Nolan.

Often transformative for patients and their families, palliative care means meeting patients where they are -– physically, emotionally and geographically -– to help them find a balance among independence, comfort and longevity. Northwest Kidney Centers introduced the world’s first palliative care program for dialysis patients in 2017.

An interdisciplinary approach

The team members share responsibilities as they bring complementary professional expertise to bear. Comprising a physician board-certified in palliative care and nephrology, a nurse and a social worker, the team’s work is done in partnership with the dialysis care team. The team meets weekly and creates tailored plans to help each of their patients cope with anything from pain and depression to insomnia and mobility issues. In addition to their specialties, team members are skilled in discussions about difficult health care decision-making, conversations about goals of care, and advance care planning for the end of life.

Palliative care
vs.
Hospice care

Appropriate at any age and any stage in a serious illness, palliative care focuses on relief from the symptoms, pain and stress for patients and families — whatever the diagnosis. Palliative care can be provided along with curative treatment and may begin at the time of diagnosis. In palliative care, you do not have to give up treatment that might cure a serious illness.

At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments. When curative measures cease, palliative care transitions into hospice care.

Like palliative care, hospice can be provided in any setting — home, nursing home, assisted living facility or inpatient hospital — it provides comprehensive comfort care as well as support for the family.

Learn more about palliative care.

Ian Shaw with a photo of his late father Louis Shaw.

The Shaw family’s experience

The palliative care team met Louis Shaw and his family in 2018 soon after Louis was diagnosed with cancer.

Louis had a large family, 16 kids spread across the county, and loved to tell staff and other patients stories about those kids. The team reached out as many of the children as they could to tell them about the seriousness of Louis’ condition and to organize an in-person meeting at his residence.

At the family meeting, youngest son and Burien resident Ian was elected to be Louis’ Durable Power of Attorney. The team began guiding Ian in his new role, while separately meeting weekly with Louis about his goals and needs.

Louis, who had been told he was too weak to survive chemotherapy, chose to get healthier and stronger. In 2019 was deemed strong enough to start chemotherapy.

As he got stronger, he met less often with the Palliative Care team, and began participating more in the activities he enjoyed and spending time with his family. Having always loved to sing, he joined the choir at his nursing home. Bingo became another pastime. One of Louis’ favorite days was when a group of his kids came and took him out fishing, a favorite pastime that he hadn’t been able to do in years.

COVID-19 restrictions cut Louis off from a lot of personal contact. Though his family spoke with him regularly by phone, in person visits were not allowed. When Ian saw Louis again in person, he did not think that Louis looked healthy, and he feared the worst: the chemotherapy was not working.

“Nobody wants to have that conversation. They [the team] really helped me,” said Ian, about the counsel he received at that time.

The team began meeting with Louis regularly, giving him reprieve from the distancing and isolation from COVID-19 restrictions. In spite of masks and personal protective equipment, “you could feel the warmth in those visits” said Jennifer Christophel Lichti.

During his last year, Louis survived COVID-19 but ultimately succumbed to the cancer in fall 2020. The palliative care team was again able to support Ian and the family during that time.

“After Pops passed away, Jennifer checked on me every month or so to talk and see if I was okay. Of course, I wasn’t, but it really helped. Then one day she called, and I told her I thought I was better. She said I sounded better. And I was feeling better,” said Ian. “She still checks in once in a while.”

Kidney Palliative Care team


Daniel Lam, MD, Medical Director
Dr. Lam is a Clinical Associate Professor of Medicine at the University of Washington and serves as the Palliative Care Medical Advisor for Northwest Kidney Centers. He believes that understanding each person’s story is vital to individualizing care. Dr. Lam’s interest in palliative care was motivated by personal experiences with the health care system, and he is especially interested in bringing palliative care to people living with kidney disease to improve their lives. His work as a 2015 Sojourns Scholar to improve palliative care access for people living with kidney disease evolved into the Kidney Palliative Care Program. Dr. Lam is board certified in Internal Medicine, Palliative Medicine, and Nephrology.

Megan Nolan, RN, BSN, Program Supervisor
Through 19 years of experience as a critical care nurse and palliative care nurse, she has found a passion for enhancing quality of life for people with serious illness. She also believes in the importance of fostering healthy work environments for health care professionals. Her professional goal is to collaborate with patients, families and other health care professionals to provide person-centered care and communication. She engages in on-going professional development and quality improvement to seek out best practices and optimal care delivery pathways. She holds a Bachelor of Science in Nursing from the University of Rochester and a Graduate Certificate in Palliative Care from the University of Washington.

Jennifer Christophel Lichti, MSW, LICSW, 
Clinical Social Worker
Jennifer brings 20 years of experience in clinical social work, specializing in palliative care since 2009. Prior to joining the team in 2020, she helped to develop and expand the inpatient and outpatient social work roles in two hospital-affiliated palliative care programs in Indianapolis. Jennifer views her transition to the dialysis center setting as an opportunity to continue learning about best practices for promoting improved quality of life for people living with kidney disease. She received a Master of Social Work degree from the University of Michigan, a Post-Master’s End of Life Certificate from Smith College School and completed a Zelda Foster Leadership Fellowship in Palliative and End of Life Care at NYU.