Palliative Care Consultation

Center for Palliative Care’s consultation program is beneficial for patients who:

  • Require specialized management of uncontrolled symptoms caused by advanced serious illness or the side effects of treatment
  • Have co-morbidities that are challenging to address during a short office visit
  • Frequently call your office with recurring concerns that are difficult for your staff to sort through and address
  • Often go to the ER or are hospitalized due to uncontrolled pain or other symptoms
  • Have been released from the hospital or a rehabilitation facility and are having difficulty managing their condition at home
  • Under-report the severity of their condition, or the difficulty of their living situation, when visiting you in the office
  • Have caregivers who are struggling to understand or manage the patient’s illness
  • Are likely on an eventual trajectory toward hospice care within the next two years
  • Want to explore their goals of care or make their end-of-life care wishes known

When Should a PC consult be considered?

The Center for Palliative Care is located at
211 N. Cedar at the Mishawaka Campus.

Advanced Disease Processes:

  • Advanced CHF (NYHA III – IV)
  • Advanced COPD
  • Advanced neurodegenerative disease (dementia, Parkinson’s, ALS)
  • Cancer (active, metastatic, recurrent)
  • Cardio-respiratory arrest with cerebral hypoxia, anoxia
  • ESLD
  • ESRD
  • Shock with MODS
  • Stroke with at least 50% decreased functional ability

Exacerbating Factors:

  • Bed-bound, dysphagia, functional decline, weight loss, pressure ulcers
  • Complex medical decision making, family disagreements, conflicts about care
  • Hemodialysis
  • Liver Disease
  • Moderate CHF, CAD to severe valvular disease, cardiomyopathy
  • Pulmonary hypertension
  • Renal disease

Other Patient Circumstances to Consider:

  • A life-limiting illness
  • Frequent visits to the ER for symptom management
  • More than one hospital admission for the same diagnosis within the last 30 days
  • Unacceptable level of pain >24 hours
  • Uncontrolled symptoms (dyspnea, nausea, vomiting, anxiety, agitation)

Patient and Family Decision-Making Support:

  • Advance care planning
  • PEG tube for artificial nutrition
  • Tracheostomy for prolonged mechanical ventilation
  • Withdrawal of ventilatory support

Office Hours:

By referral and appointment only. Please call 574-367-2476 to schedule an appointment. The Center for Palliative Care is located at 211 North Cedar, Mishawaka, IN 46545. For more information or to request a tour, please email