Dr. Glen Komatsu is a nationally-renowned physician and innovator within the palliative care field—who also introduces himself as a Sansei and the son of a farmer, as important to his identity. In 2017, Dr. Komatsu approached Keiro with a seed of an idea: A partnership which would provide culturally-sensitive palliative care to older adults within the Japanese American and Japanese community. From this seed sprouted Iyashi Care, named after the Japanese word that means “to heal.”
Palliative care is a specialty of medicine where a team of professionals—including doctors, nurses, social workers and chaplains—collectively supports a patient with a serious illness and their families. “The care is provided in addition to your regular doctors, and it provides an extra layer of support to try and relieve the stress of chronic or terminal illness,” Dr. Komatsu explained. He works for Providence, a health system with a long-standing commitment to building and growing excellent palliative care programs.
Budding Relationships with Iyashi Care
Iyashi Care grew from a partnership between Keiro and Providence, where Dr. Komatsu serves as regional chief medical officer of palliative care and hospice. He describes this collaboration between Keiro and Providence as an innovative program to serve the Keiro community. “It turns out that we have similar missions, which is improving the health of the communities that we serve. It was a tremendous opportunity for us to partner together to act on that vision and make it a reality for the Japanese and Japanese American population,” he said.
The Japanese cultural focus of Iyashi Care also makes it both familiar and distinct within the field of palliative care. The Iyashi Care team includes bilingual professionals in Japanese and English—and yet, as Dr. Komatsu notes, building culturally-sensitive relationships with patients includes more than speaking Japanese or being familiar with Japanese or Japanese American culture. “One of the foundational principles I teach in palliative care is the concept of cultural humility,” Dr. Komatsu said. “Every patient and family are unique. Our job, as palliative care clinicians, is to learn the specific culture of that patient and family, how they interpret being Japanese or Japanese American, how they live their lives, what is important to them, how spirituality is expressed in their lives. Each individual and their family have a unique culture which we need to understand and appreciate.”
Letting Palliative Care Take Root
Dr. Komatsu looks back on when Iyashi Care first started in 2017, recalling, “I told everybody at the beginning: Be prepared for a slow start. Palliative care only became a specialty of medicine in 2006. People don’t know what it is, and there’s no other existing comparable program. This is going to take time.”
Over time, the program has grown. According to Dr. Komatsu, an early barrier was confusion over whether palliative care was the same as hospice care. They are similar and related, but palliative care can support patients at any stage of their illness—as early as the first diagnosis of a serious illness—and can provide support while patients seek curative treatment. Hospice care is a Medicare-defined benefit which provides palliative care in the last six months of their life, when patients cannot be cured. He explained, “Whole Person Care is something that all patients should receive. But people focus only on cures and aggressive treatment rather than realistic goals and quality of life – which contributes to their pain and suffering. When people experience palliative care support, they and their families feel incredible relief and support.”
On Blossoming – and Looking Towards the Next Season
Three years after starting Iyashi Care, the program has provided support to over 250 patients and counting. Dr. Komatsu feels great pride when he sees the team fulfill the vision of care he imagined. He described, “I sit next door to Dr. Yanami (Iyashi Care lead physician), and I hear him chattering away in Japanese all day long, talking to patients and families, and I know he’s helping them. I know he’s providing them with expert advice with a kind and compassionate presence. The same with Kanako, Miho, and Josh—I know how committed they all are to taking care of these patients and their families. With Keiro’s support, we’ve assembled a stellar team, and it’s a source of joy to me to see them helping people every single day.”
Dr. Komatsu looks forward to seeing the program continue to flourish and grow in future years to help more in the community. “I don’t foresee any other organization or any other groups with the resources and exposure to serve the Japanese and Japanese American community like Iyashi Care does. Our population is aging and the need for Iyashi Care will only grow,” he mused. “My hope is that it will continue indefinitely, to serve this community.”
Give Us a Chance to Help
When asked about one thing he wanted the community to know about Iyashi Care, he shared, “I’d like them to give us a chance to help them and earn their trust. When you offer services that are free, people are naturally suspicious. When you offer services that are new, that they have never heard of, they are naturally skeptical. So, I would ask the community to give us the chance to help.”
“The influence of palliative care is only growing greater. People are living longer and longer, it’s a good thing but with that, it means they have longer periods of disability and hardship. And we see that in Iyashi Care. People are living to their 90s, 100s but they need help, they have multiple challenges, they have caregiving needs, their families are struggling to care for them. Iyashi Care really helps fill that need that people and their families have to care for their aging loved ones.”－Dr. Komatsu