The Enfold Palliative Care Service was started by Dr Margie Venter in 2017. She is a qualified Clinical Oncologist with a special interest in Palliative Care. Enfold offers the following services.

01. Oncology supportive or palliative care consultations

Dr Venter does not offer any oncological treatment. She does, however, work closely with the patient’s oncologist to optimize a patient’s quality of life. This care is appropriate from the time of diagnosis and is offered alongside the patient’s usual oncology treatments such as chemotherapy or radiotherapy. Where do they happen? Consultations happen in office or in hospital. Duration of consultations? They usually last about 45 minutes to an hour. Consultations focus on:

  • Controlling symptoms such as pain, fatigue, breathlessness and nausea.
  • Extra time is spent on
    • understanding all the medical information that has been provided to so far and filling in the gaps if needed
    • knowing what to expect
    • knowing which questions to ask
    • helping to make medical decisions about often confusing or complicated treatment choices and options
    • matching a patient’s personal goals and values to their medical care
    • knowing which support resources are available
  • Introducing other care providers such as a psychologist or physiotherapist to the team, depending on your needs.
  • Coordinating a patient’s care.

What do they cost? Initial consultations cost R1250 and are payable directly to the practice. Ongoing consultations will be motivated for with your medical aid but unfortunately few medical aids have palliative care benefits.

02. Palliative care consultations for other diagnoses

Enfold offers palliative care consultations for other diagnoses such as chronic kidney or heart failure, chronic obstructive lung disease or degenerative neurological diseases. Again, the primary care remains with the physician but help is offered with symptom control and advance care planning.

Advance care planning is a conversational process whereby we figure out what kinds of medical treatments you would want or not want in cases where you are not able to verbalize these decisions for yourself. It would depend on what things you value most in life and what trade-offs you might be prepared to make. Part of this process includes appointing a health care proxy and documenting it all so that it can be shared with your healthcare team and other important people in your life.

03. End-of-life care

One component of palliative care is end-of-life care. At this point treatment of the disease itself is usually suspended, and treatment focuses on the person instead, ensuring quality of life is maintained.

This service is offered to patients living in Stellenbosch. Care is offered within a multidisciplinary team which would include Dr Venter as palliative care doctor, your general practitioner, one of the Stellenbosch hospice nurses, a social worker and other healthcare providers, depending on your needs.

The care needs of a patient as a whole are addressed, including controlling of symptoms as well as emotional, social and spiritual needs. Support is also given to the family.

Patients can be seen in the office, in hospital or at home, depending on the situation.

Payment claims will be submitted directly to medical aids with no co-payments required.

Several general practitioners in town, along with the Stellenbosch hospice, have joined forces to offer after-hour telephonic support to patients and their families. Care is coordinated in such a way, that even if you have to access care in the emergency room, the care you receive will be consistent with your previously discussed goals and wishes.

The care team communicates efficiently using a secure text messaging system called Signapps, ensuring that everyone is always on the same page. They also meet once a month to discuss patient cases. It has been shown that a team working together in this way improves the general quality and level of patient care.