Full Course Description


Nearing the End of Life: Dare to Care

Program Information

Objectives

  1. Analyze how complementary therapies enhance quality of life for patients.
  2. Evaluate the risks and benefits of medical marijuana.
  3. Categorize the eight domains of the National Consensus Project.
  4. Analyze five complications related to artificial hydration and nutrition.
  5. Assess ethical issues often seen at the end of life.
  6. Formulate two strategies to diminish fear of death and dying.
  7. 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

  1. Measure the assessment scales that are predictive of poor survival.
  2. Debate the importance of prognosis and shared decision-making.
  3. Evaluate the benefits of using palliative care principles for patients with end stage disease.
  4. Distinguish palliative services vs. hospice services.
  5. Choose strategies to help patients overcome the fear of death.
  6. 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

  1. Differentiate between various palliative-specific wound care treatment interventions.
  2. Choose the best strategies to manage drainage, odor, bleeding and wound pain.
  3. Evaluate atypical types of wounds and appropriate symptom management for each.
  4. Plan for management challenges that can present with complex fistulas.
  5. Prepare for the emotional and psychological effects of end of life wounds for patients and families.
  6. 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

  1. Determine common needs of the dying and ways to meet across many health care settings
  2. Employ ways to discuss end of life issues while allowing miracles and hope
  3. Distinguish the differences and commonalities of palliative and hospice care models
  4. Evaluate anticipatory grief and how it shapes the end of life experience for patients and families
  5. Apply tools and techniques to manage our own reactions to loss in the workplace
  6. Manage and resolve conflict regarding advance directives and code status
  7. Utilize tools to help children cope with a love one dying
  8. Assess common characteristics of deathbed visions and normalize them for families
  9. Prepare techniques for running a successful family conference
  10. Justify how fears about pain addiction can play a role in family dynamics at the end of life
  11. 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

  1. Develop meaning-making principles to assist clients coping with various types of loss.
  2. Formulate ways to use meaning to help clients remember with more love than pain.
  3. Evaluate techniques for using meaning to help clients resolve the internal struggle of “why did this happen?” and “why did this happen to me?”
  4. Determine why children are often the forgotten grievers and how to help them through their grief.
  5. Develop strategies that incorporate meaning mechanisms to help clients cope with complicated grieving.
  6. 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