When nursing student Amelia Brennock ’25 traveled to Florence, Italy in June 2023 as part of a study abroad immersion trip, she was looking to gain a new perspective on palliative care and international healthcare systems.

The week-long immersion trip was part of a course led by faculty members Michael Pagano, PhD, PA-C, professor of communication, and Eileen O’Shea, DNP, APRN, PCNS-BC, CHPPN, professor of nursing and director of the Kanarek Center for Palliative Care.

“I was inspired to take this course because of my own background: I had acute lymphoblastic leukemia twice in my life, and palliative care was an integral part of my treatment,” said Brennock. “I wanted to learn more about palliative care and compare the U.S. versus Italy, to gain another perspective of a differing healthcare system.”

Palliative care is an area of growing focus in heathcare, developed “to provide individuals not a cure per se, but a quality of life that allows them to do as many things as they are capable of doing, by managing difficult symptoms, alleviating or lessening pain, and collaborating with an interdisciplinary care team,” explained Dr. Shea.

Arriving in Florence in early June, Brennock and her fellow students attended lectures at Florence University of the Arts, explored the historic city, and visited area hospitals, long-term care facilities, and museums related to healthcare.

Italy was chosen as the destination for the immersion trip due to its different approach to healthcare delivery. Dr. Pagano explained: “Everyone in Italy, citizens and immigrants, have universal access to healthcare, as compared to the U.S. with its different levels of care based on ability to pay. We wanted to see how these socioeconomic status differences, coupled with Italian culture distinctions would impact not only access and delivery of palliative care, but the country’s communication about it.”

The students first arrived at the palliative care unit of the Meyer Children’s Hospital on the third day of their trip. Set in Florence’s hillside, the facility’s parklike setting features large trees and tropical plants. The building has a sustainable green roof, a garden, atriums with robust natural light, open spaces, art, and a playroom for children.

“[It] felt like I was in a children’s museum,” said nursing student Macey Brown ’26. “I found it heartwarming to see patients – young kids – get excited to walk in, because this beautiful building has been made to feel like a home away from home.”

The group also traveled to a northern suburb of Florence to visit Careggi University Hospital, the largest acute-care hospital in the region. As they toured Careggi, the students noted the large expansive windows that fill the space with natural light. Behavioral neuroscience major Zana Imeptovski ’24, who plans to pursue a career path as a physician’s assistant, said that the windows and natural light “definitely benefit patient morale.” She observed that at the hospitals in Italy, “healthcare teams create a patient-centered focus and advocate for the patients’ wants and needs, ultimately improving quality of life.”

Following the hospital visits, the group was introduced to a nursing home in Florence — Casa Di Pioso Piccola Betania, or, the Little Bethany Rest Home. There, they attended a music therapy session and danced with the residents who serenaded them with an Italian song they wrote. “I was taken aback by the stark contrast between U.S. nursing homes and those in Italy,” said Imeptovski, whose grandmother recently died in a U.S. nursing home. “When we were all dancing together, I remember taking in the moment and feeling pure joy. I also remember tearing up during the tour, because the woman who was volunteering to show us around reminded me so much of my grandmother. I just kept thinking about how much she would have enjoyed this place and how much I wished I could talk to her about my trip.”

In addition to the healthcare site visits, the students toured the Museo degli Innocent, which, from 1445 to 1890, was a hospital and orphanage for infants and children whose parents were not able to raise them. They also visited Museo della Misericordia, a site dedicated to the volunteer ambulance service, which dates back more than 770 years.

“Italy surpasses the United States in palliative care...by a mile,” Brennock said. “Palliative care is a law-established philosophy for children, and you can see that their quality of life is ten times better because of it.”

She noted that Italy is significantly better at their patient-provider interactions due to the care system being more patient-centric, while the United States follows a biomedical model of “find it, fix it.”

However, she found that the United States gives patients better access to healthcare providers. In Italy, wait times to receive care can be very long, and patients are required to go through a general practitioner before they are able to see specialists.

Reflecting on the immersion experience, Imeptovski said, “This course made me cognizant of issues in medical communication and also taught me that the goal at the end of the day is to improve the quality of life of the patient. As a future provider, I plan to listen to everything my patient has to say.”

Learn more about palliative care and the Kanarek Center for Palliative Care at fairfield.edu/kanarek.

Robin Bennett Kanarek '96 RN, BSN: Living Well With A Serious Illness

This spring, former University Trustee Robin Bennett Kanarek ’96 published a book, Living Well with a Serious Illness: A Guide to Palliative Care for Mind, Body, and Spirit, inspired by both her work as a registered nurse and her late son David’s five-year battle with acute lymphocytic leukemia.

It was during David’s taxing treatments that Kanarek realized the need for palliative care for patients and their families. Ever since David’s passing, advancing the field of palliative care has become her mission.

“The books available on palliative care were either geared toward healthcare professionals or only included a chapter on palliative care,” said Kanarek. She said she wrote her book “so the consumer has all the information they need to make the right decision for themselves about the care they want to receive if they are diagnosed with a serious illness or have complex chronic conditions.”

“I also wrote the book to honor the life of my beloved son, David, who died after a five-year ordeal with leukemia and complications following a stem cell transplant,” she added. “David was 15 when he died. My book honors the remarkable young man he was, who taught us about what is truly important – love and family.”

Using her own experience, information in Kanarek’s book helps patients and their families not only to understand what palliative care is, but also how it can improve quality of life. It explains how to navigate and access support resources, advanced care planning, coping techniques, spiritual care, and strategies for each stage of the journey.

Kanarek explained, “Many medical professionals don’t understand the full spectrum of palliative care. They use the terms ‘palliative’ and ‘hospice’ care interchangeably. Providers may need clarification that there is a distinct difference between the two; the book outlines those differences and describes the full scope of palliative care.”

Opened in fall 2017, Fairfield Egan’s Kanarek Center for Palliative Care prepares students to be leaders in the field.