Integrated Family Care: A Revolutionary Approach to Complex and End of Life Care

During my thirty-year career in medicine there have been a few “aha” moments that dramatically influenced my course. I believe the most profound “aha” moment was in 2013, when I heard a voice from within tell me, “you are here to help people die.” That message was unexpected, but it clearly landed with me, and changed everything.

End-of-Life Care and my “aha” Moments

Since that time I have found my calling, and am driven by a desire to help people experience the most peace of mind and comfort as they navigate their life and death journeys. My team and I help people live better despite being ill, despite being “terminal”.

We help people experience more joy, and less fear, regardless of their external circumstances. We help them have more comfort and less pain. More control, and less powerlessness. And when the time comes, as it eventually does for us all, we help people have a soft landing.

Some Call it Hospice – we Call it Soft Landing

A soft landing is what we strive for- a peaceful, empowered and dignified last season of life, and death. It’s what we all deserve, yet only a few of us are fortunate to achieve it. I believe I am an instrument of change in the movement to help people die better (and live better leading up to their death). That all came from an “aha” moment. I had another “aha” moment very recently, which I want to share with you.

At home the other day I was thinking about the important work we do at Integrated MD Care, reflecting on why it works so well. These questions came up: 

  • Why do our patients and their families all over San Diego County feel such gratitude about their experience with us?
  • Why do they so often feel compelled to stay in contact with us, even after their loved one, our patient, has died?
  • Why does the personal attention we show each patient seem so unusual in our healthcare world?
  • Does it work because we’re willing to come to the home to provide care?
  • Does it work because of the Integrative Therapies we offer?
  • Does it work because of our ability to make people smile and laugh, even though things are difficult?

Since we started the practice over three years ago, the answer to these questions have eluded me.

All of a sudden, I sat bolt upright and felt that familiar, electric sensation of “knowing” as it came to me. It seemed so simple, and yet revolutionary at the same time. We don’t only do patient care, we do family care. We don’t just care for the patient. We care for the entire family. We provide Integrated Family Care.

Beyond Palliative Care – More Than Hospice

This is one of the most profound differences between what we do and what other medical practices do. What sets us apart is our commitment to being there for the families and loved ones. Showing up for them. Supporting them. Sustaining them. Of course it’s a palliative approach and our deep understanding of hospice is part of the foundation of our services, but end-of-life and complex care is so much more than just hospice and palliative care.

The traditional healthcare system has no mechanism for taking care of the families. The doctors and nurses caring for patients don’t have time to dedicate to exploring the goals and wishes of the families, let alone meet their needs. If they devote time to the family, they’re taking time away from the patient. There’s no extra time.

Also, there is no way for doctors to get reimbursed for spending time counseling, reassuring, educating or just connecting with family members. So the family members are under-supported, under-informed, confused, frustrated, afraid, and often angry.

When their loved one is newly diagnosed with a significant illness, undergoing therapy, in and out of the hospital, or facing the inevitable final days of life, family members heavily influence the experience of the that patient.

Families with adequate support and guidance can help make appropriate and well-considered decisions. Families without adequate support and guidance (the vast majority) often make decisions out of fear and a misaligned sense of duty– decisions that often result in unnecessary ER visits and hospitalizations, inappropriate nursing home or hospice admissions, or more futile treatments and aggressive procedures.

Complex Care and Confused Caregivers

Uniformed, unsupported and overwhelmed loved ones are responsible for a significant amount of unintentional (and irreversible) struggle for the patient. When loved ones look back at the way they cared for their mom, or dad, or husband or wife, or sibling, or child, or friend, their belief about how they supported them will have an impact on them forever.

Caring for family members and friends who are caring for an ill or dying loved one has far-reaching consequences, well beyond what they are experiencing in the moment. Well beyond the impact it has on the actual care and experience of the patient. Taking care of those who are caring for seriously ill and/or dying loved ones can prevent years- decades- of guilt, regret and anxiety that can be, and should be, avoided.

Whether we are providing In-Home Primary Care for a 90 year old woman with dementia, Complex Care in the Home for a 75 year old man with advanced heart failure or Compassionate End of Life Care for a 50 year old dying of brain cancer, the family and loved ones become our clients- our patients- just as much as, and in some cases even more than, the patient themself. With us, it’s a package deal. It’s Integrated Family Care.

Of course we provide excellent care to our patients whether they are in Solana Beach, Hillcrest, Escondido, Carlsbad or anywhere in Southern California. No matter where you live, excellent care is a given. But I believe what truly sets our model apart is the way we show up for, care for and sustain the loved ones who are doing their best, but struggling under the weight of their unfamiliar and unrelenting burden.

Realizing the critical importance of meeting the needs of the loved ones taking care of the patient is one of our primary focuses, and while it can be taxing and challenging at times, it is how we are able to fulfill our mission of eliminating fear and confusion, replacing it with peace and empowerment.

Difference Between Palliative Care, Hospice, and us

In the coming months I will be sharing more about this critically important understanding and sharing how we plan to spread the word about Integrated Family Care. What we’re working on is beyond palliative care and more than hospice care.

We are in the process of developing educational and training programs to deliver to other health care providers so they can learn how to incorporate this revolutionary concept into their own model of practice.

Please stay tuned, and feel free to connect with us and share your own reflections on how to ensure the most peace, comfort, empowerment and dignity as we head down the path toward our inevitable destiny.

To learn more about our revolutionary model of Integrated Family Care or to experience it for yourself, please reach out and connect with us. If you have any questions about palliative care, hospice, or our revolutionary approach to healthcare, please pick up the phone or drop us an email!

There is no cost or obligation to set up a phone consultation. 


About Dr. Bob Uslander. 

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