Full Course Description
Nearing the End of Life: Dare to Care
Program Information
Objectives
- Analyze how complementary therapies enhance quality of life for patients.
- Evaluate the risks and benefits of medical marijuana.
- Categorize the eight domains of the National Consensus Project.
- Analyze five complications related to artificial hydration and nutrition.
- Assess ethical issues often seen at the end of life.
- Formulate two strategies to diminish fear of death and dying.
- Connect moral resiliency to palliative care.
Outline
- An Inexact Art & Science
- Illness and dying trajectories
- Frailty
- Dementia
- Prognostication and prognostic scales
- When to refer to palliative care or hospice (disease specific)
- Essentials of Care: Comfort, Communication, Choices, Control
- Comfort Always
- Morphine: Still the gold standard?
- Pain during the final hours of life
- Drug misuse: How to avoid it
- Opioids for dyspnea
- Thirst vs. xerostomia
- Medical marijuana
- Complementary and alternative therapies
- Emotional distress interventions
- The role of spirituality
- Palliative sedation
- Communication: Everyone is Involved
- Advance care planning: More than just a form
- The terminology matters
- Your role in these critical conversations
- How much can we share?
- Truth vs. hope
- Code status discussions
- DNR does not mean do not treat
- Addressing concerns and needs of the family
- Thanatophobia: Is it fear of dying or fear of death?
- Premortem surge
- Near death awareness
- The dying process
- Choices: Shared Decision-Making
- Nutrition & hydration choices
- Voluntarily Stopping Eating and Drinking (VSED): Benefits & burdens
- Life-sustaining treatment
- Non-beneficial treatment choices
- Faith-based influences
- Ventilator support
- Dialysis or renal palliative care
- Devices to extend life
- Hastened death request: Why not humanely euthanize?
- Allowing Control: Patient-Centered Care
- Reframing hope
- What do family members want you to consider
- Who makes the decision
- What about family dysfunction…
- Is the focus quality or quantity?
- Decision to withhold or withdraw care
- Challenging decisions: Honoring patients’ wishes
- Cultivating Moral Resiliency
- Moral resilience–preserving/restoring integrity
- Personal vs. professional grieving
- Enabling character and honorable action
- Ethical Competency
Target Audience
Nurses, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, Social Workers, Counselors, Case Managers, Chaplains, Clergy
Copyright :
03/09/2018
Care When There is No Cure for Patients with End Stage Diseases
Program Information
Objectives
- Measure the assessment scales that are predictive of poor survival.
- Debate the importance of prognosis and shared decision-making.
- Evaluate the benefits of using palliative care principles for patients with end stage disease.
- Distinguish palliative services vs. hospice services.
- Choose strategies to help patients overcome the fear of death.
- Predict challenging end of life symptoms and the best interventions.
Outline
Disease Prognostication: An Inexact Art & Science
- Individualized care: The importance of prognosis (science/art/intuition)
- Determining palliative care vs. hospice care
- Crucial conversations
- The hospice benefit
Congestive Heart Failure: The Broken Heart
- Best practice: The Seattle HF Model
- Medication management strategies
- Symptom management and pain management
- Pacemakers, ICDs & LVADs - Living better or prolonging suffering?
Chronic Obstructive Lung Disease
- Global Obstructive Lung Disease (GOLD) Guidelines
- The COPD Assessment Test (CAT)
- Treating dyspnea: "The Pain of Non-Malignant Disease"
- The medication tool box: Oxygen, bronchodilators, opioids and steroids
Renal Disease
- Appropriate use of dialysis
- Staging disease with Glomerular Filtration Rate
- Hemodialysis mortality predictor
- Symptom burden
- Underutilization of hospice
- Opiods with dialysis
Liver Disease
- Indicators of poor prognosis
- Differentiating when cirrhosis is the cause
- Most useful analgesics for the pain
- Waiting for transplant while on hospice: Use of the MELD tool
Advanced Dementia
- GDS: FAST
- Pain scales
- Feeding tube dilemmas - and outcomes
- Delirium and dementia: Interventions for agitation and aggression
- End state dementia
Amyotrophic Lateral Sclerosis
- Diagnostic tests for ALS
- Advance directives and life support decisions
- Nutrition and gastrostomy
- Non–invasive ventilation
- Table of useful medications and palliative measures
Advanced Cancer
- The value of early palliative care
- Spiritual needs
- Complications and interventions
- Spinal cord compression
- Superior vena cava syndrome
- Bowel obstruction
- Hypercalcemia
- Fungating wound/terminal Kennedy ulcer
Eight Signs of Impending Death
Challenging Decisions
- What do people want at the end of life?
- Delirium vs. near death awareness
- Mental health needs of the dying
- Palliative sedation therapy for intractable symptoms
- Does the dying person need hydration? Oxygen? Treatment for rales?
Moral Distress
- Uncomfortable patient/family scenarios
- Ethical dilemmas
- Medication errors
- Conflicted consciences
Target Audience
- Nurses
- Nurse Practitioners
- Clinical Nurse Specialists
- Social Workers
- Counselors
- Case Managers
- Chaplains
- Clergy
Copyright :
11/30/2018
Palliative Wound Care: Management of Complex and Unique Wound Challenges at the End of Life
Program Information
Objectives
- Differentiate between various palliative-specific wound care treatment interventions.
- Choose the best strategies to manage drainage, odor, bleeding and wound pain.
- Evaluate atypical types of wounds and appropriate symptom management for each.
- Plan for management challenges that can present with complex fistulas.
- Prepare for the emotional and psychological effects of end of life wounds for patients and families.
- Appraise symptoms of stress/burnout/ compassion fatigue in your life.
Outline
- The Infected Wound
- Contamination, Colonization and Infection
- Optimal Culturing for an Infected Wound
- Reducing Unnecessary Antibiotic Usage
- Reducing Biofilms
- Impact of Nutrition/Labs
- Prealbumin vs. Albumin - and What to Do with the Results
- Glycemic Control and Wound Healing
- Ways to Enhance Nutritional Intake
- Choosing a Debridement Method
- Autolytic
- Enzymatic
- Mechanical
- Conservative Sharp
- Maggot Therapy
- Wound Types and Etiologies
- Pressure Ulcers and Staging
- Pressure… Seeing the Tip of the Iceberg
- Tools for Predicting Pressure Ulcer Risk
- Early Detection of Deep Tissue Injury
- Incontinences Associated Dermatitis vs. Pressure Ulcers
- Venous Stasis Ulcers
- Where is All This Fluid Coming From?
- Lymphedema
- Feeling the Squeeze… Different Degrees of Compression
- Arterial Ulcers
- Arterial Perfusion
- Claudication and Rest Pain
- Diagnostic Tests: Vascular Studies and ABIs
- Diabetic/Neuropathic Ulcers
- Assessing Sensation
- Bad to the Bone… Osteomyelitis
- Skin Tears/ Adhesive Injuries
- Is it Partial or Full Thickness Loss?
- Managing Xerosis with Products in Your Kitchen!
- Moisturizing and Skin pH…
- Time Out: Identify Wound Types Through Actual Patient Pictures
- Making Sense of the Endless Dressing Options
- Foams
- Alginates and Hydrofiber
- Hydrogels
- Thin Films
- Negative Pressure Wound Therapy
- The Magic of Honey
- Contact Layers
- Alternative Homeopathic Approaches to Wound Care
- Hands-On Intensive Interactive Session: Wound Products & Homeopathic Treatments
- Management of End of Life Wounds
- Managing Drainage
- Bleeding and Use of Monsels Solution
- Odor and Use of Metronidazole
- Disfigurement and Loss of Being Touched
- Skin Failure
- How to Recognize It
- How to Document It
- How to Explain to Caregivers What’s Happening
- Recognizing Atypical Wounds
- Management of Fungating/Malignant Wounds
- Calciphylaxis
- Pyoderma Gangrenosum
- Kennedy Ulcerations
- Pruritis and Xerosis
- Time Out: Management of Unavoidable Wounds & Actual Patient Scenario Discussion
- Fistula Solutions
- Containment of Effluent and Odor
- Protecting Surrounding Tissue
- Fistula Containment Management System: Hands-On Fistula Management Systems
- Understanding Wound Pain and Treatment Options
- What Type of Pain is it?
- Reducing Pain with Dressing Changes/
- Wound Care
- Use of Topical Opioids for Wound Pain
- Documentation Strategies for Unavoidable Wounds
- Describing Patient Function and Charting Patient Decline
- Documenting Prevention Strategies
- Discussing Realistic Outcomes with Patient and Family
- Avoiding Wound Care Litigation
- Burnout vs. Compassion Fatigue
- Identifying Your Own Stress and Anxiety
- Seeing Suffering Every Day
- How Stress & Guilt Affect Your Body
- Developing Resilience
- Maintaining a Sense of Hope
- Life Balance Exercise: Building A Personal Resiliency Plan
Target Audience
Nurses, Nurse Practitioners, Physician Assistants, Physical Therapists, Nursing Home Administrators
Copyright :
03/23/2018
Understanding the Needs of the Dying: Bringing Hope, Comfort and Love to Life's Final Chapter
Program Information
Target Audience
Chaplains/Clergy, Counselors, Marriage & Family Therapists, Nurses, Psychologists, Social Workers, Thanatologists and other Mental Health Professionals
Objectives
- Determine common needs of the dying and ways to meet across many health care settings
- Employ ways to discuss end of life issues while allowing miracles and hope
- Distinguish the differences and commonalities of palliative and hospice care models
- Evaluate anticipatory grief and how it shapes the end of life experience for patients and families
- Apply tools and techniques to manage our own reactions to loss in the workplace
- Manage and resolve conflict regarding advance directives and code status
- Utilize tools to help children cope with a love one dying
- Assess common characteristics of deathbed visions and normalize them for families
- Prepare techniques for running a successful family conference
- Justify how fears about pain addiction can play a role in family dynamics at the end of life
- Defend the role of spirituality and its role in the last years of life
Outline
Signs of Impending Death
- Preparing family for physical changes
- Interventions for coping with emotional changes in the family
- Using near death awareness as a predictor in clinical settings
Palliative Care Model
- Academic settings vs community
- Physician led vs non physician led
- Roles of physician, nurse, social worker, case manager, discharge planner, clergy
- What’s best - hospital, home health, hospice, skilled nursing facility
- Joint commission certification
Hospice
- Removing barriers
- How hospice can increase length of stay while decreasing hospital time
- Bereavement services to enhance community partnerships
Death Related Sensory Experiences (Death Bed Visions)
- Effective and ineffective models for family coping and integration
- Religion in patients’ deathbed visions
- Using the law to normalize the dying experience
- Clinical/palliative care studies, research of near death awareness
Advance Directives
- Physician order for life-sustaining treatment
- Make advance directives useful and medically effective
- D.N.R. (do not resuscitate) vs. A.N.D. (allow natural death)
- Code status and impact on the grieving process
Anticipatory Grief
- Treatment strategies for hospice, palliative care and mental health care professionals
- Tools for normalizing
Helping the Dying Patient’s Children
- How the media shapes a child’s view of death
- Tools for preparing a child for loss
- Interventions for coping with funerals
- Why children are often the forgotten grievers and how to help
The Ethics Committee and End of Life
- How and when to use your ethics committee
- How and why members of the end of life team can participate
- Techniques for helping families get the most out of the ethics meetings
- Avoid the common pitfalls of ethics committees at the end of life
Hope and Miracles
- How to help families integrate desire for miracles at the end of life
- Techniques for honoring hope without fostering denial
Cultural Differences
- Affecting care of the dying
- Tools for successfully bridging the gap with healthcare providers and families
The Question of Assisted Suicide
- Understanding the current debate
- The realities of withdrawing care vs. assisted suicide
- Learn techniques for addressing patient’s requests for assisted suicide within the facilities and health care provider’s beliefs system
Copyright :
04/18/2016
David Kessler: Finding Meaning: The Sixth Stage of Grief
Program Information
Objectives
- Develop meaning-making principles to assist clients coping with various types of loss.
- Formulate ways to use meaning to help clients remember with more love than pain.
- Evaluate techniques for using meaning to help clients resolve the internal struggle of “why did this happen?” and “why did this happen to me?”
- Determine why children are often the forgotten grievers and how to help them through their grief.
- Develop strategies that incorporate meaning mechanisms to help clients cope with complicated grieving.
- Utilize strategies to help clients address guilt, shame and stigma associated with grief.
Outline
The Sixth Stage of Grief: Finding Meaning
- Why the stages were never meant to be linear
- What is making meaning in grief?
- Types of meaning making
- How meaning can help remember the person who died with more love than pain
- Why a sixth stage is the key to recovery from grief
- Keys to finding acceptance and moving into the sixth stage
Witnessing vs “Fixing” Grief
- Mirroring techniques
- The cost of trying to “fix” those who are grieving
- Go beyond active listening skills to connect
- The consequence of trying to find meaning too early
Help Clients Change Their Thinking Around Loss
- Strategies to address guilt, shame and stigma in grief
- How to increase resilience after loss
- Use positive psychology to increase the possibility of post traumatic growth
- Understand the “meaning” we attach to the traumatic loss or death
- How to decrease catastrophizing after loss
- Learn ways to instill good memories instead of painful ones
Complicated Grief
- Simplifying grief models and exploring new models, including resiliency and Option B
- Meaning making as a new tool for dealing with murder, multiple losses, Alzheimer’s
- Techniques for strength-based grief counseling
- Post traumatic growth vs Post traumatic trauma
- Techniques for releasing the obsessive replaying of the trauma/death
Help Bereaved parents
- Understand the impact of child loss
- Learn ways to be comfortable with treating this type of loss
- Techniques for helping parents who are often grieving differently
- Learn ways to help sustain the marriage through tremendous loss
- Ways to help parents deal with the discomfort of living and loving again
- Address intimacy issues that may come up in grief
The Grief of Suicide
- Tools for dealing with the “what if’s” and “if only’s”
- Understand the true “why” of death by suicide
- Ways to help others find peace again
Loss by Addiction
- Meaning making for healing self-blame
- How to help loved one’s sort through the shame and isolation
- Understand the roles they did and didn’t play in an addiction death
Shootings and Other Disasters
- Shootings/hurricanes/earthquakes and terrorist’s acts
- Techniques for approaching horrific crime and/or disaster scenes
- The impact of natural vs. manmade disasters
Healing Grief in Divorce
- Use meaning to reframe divorce and heal shame
- Heal after betrayal by understanding its meaning
- Understand the true meaning of marriage after it ends
- Interpret the meaning behind negative reoccurring patterns
- Negative meanings we make after a relationship ends
Healing Complicated Relationships after Death
- Learn techniques to heal a relationship after death
- Understand patterns that can heal that relationship and help in all future relationships
- Learn ways to help your client find peace in difficult relationships
Meaning and the Afterlife
- Effective and ineffective models of continuing connections for living a full life
- Use the model of continuing bonds and connections for healing
- Learn ways to normalize client experiences around continued connections with loved ones that have died
Target Audience
- Counselors
- Social Workers
- Psychologists
- Physicians
- Nurses
- Case Managers
- Marriage & Family Therapists
- Addiction Counselors
- Thanatologists
- Chaplains/Clergy Hospitals
- Palliative Care Services
- Hospice Professionals
- Funeral Directors
- Other Mental Health Professionals
Copyright :
03/12/2020