Full Course Description

Module One | Nearing the End of Life: Dare to Care

Families ask . . . what would you do if this were your loved one? Learn how to reply without bias …
Creative ways to discuss withdrawing or withholding treatment
Manage patient pain and symptoms: Medical marijuana, morphine, palliative sedation or fewer medications?
Tips to guide code status conversations with patients and families
Resolve family dysfunction surrounding end of life decisions
Requests to “humanely euthanize”/hastening death: How to respond?
Hear powerful case studies that provide examples of expert, holistic care

Eleanor is an 83-year-old widowed lady with known chronic heart failure and advanced dementia. She is now hospitalized with a significant stroke and dysphagia. She does not have a healthcare directive and had never discussed what she would want, other than staying at home until she dies. She is full code. Her family still wants resuscitation attempted. Her children admit they are concerned about what is best for their mother.

What are options for Eleanor and her family? Would she benefit from artificial hydration and nutrition? How is she going to receive medications? Can some of her medications be discontinued? Who is going to be her caregiver?

In this compelling seminar, multiple case studies like Eleanor’s will provide you with examples that you can incorporate when care is more important than cure. To deliver expert, holistic care, healthcare professionals need to have a toolbox full of new interventions to promote quality care at the end of life.

Have you ever been asked, “what would you do if this was your family member?” Learn conversation options to use while staying neutral.

Did you know that a patient might enroll on hospice care and be a full code? We will discuss how this is done.

What can we do for patients seeking euthanasia who see this as the best solution? These situations are becoming more frequent. Anticipate how you will respond.

Strategies regarding comfort, communication, choices and control have unique issues and challenges for patients, families and health professionals. We have an obligation to know how to help provide emotional, spiritual, existential, and physical comfort for those who have life-limiting conditions and to support them through difficult decisions. It’s time to think outside the box.

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

Module Two | Nearing the End of Life: Dare to Care

Copyright : 03/09/2018

Module Three | Nearing the End of Life: Dare to Care

Copyright : 03/09/2018

Module Four | Care When There is No Cure for Patients with End Stage Diseases

Preserving a patient's legacy - Harold's story…

Harold was a patient with metastatic bowel cancer - he had just months to live. Over his lifetime, he had been instrumental in transforming acres of farmland into the village that he grew to love. This legacy was extremely important to Harold. In an effort to keep this heritage alive, he had large posters made of photos, and he even used his carpentry skills to create an entire model of the town. Upon hospice visits, his only focus was teaching his caregivers about this legacy; he did not want it lost with his death.

His caregivers began videotaping him sharing the story of his village – but that wasn't enough for Harold. With his permission, a local TV station was brought in, focusing on the model, photos, and the stories behind them. The TV personnel never mentioned that Harold was ill. The video aired on the local station, and Harold was ecstatic - and at peace. He passed away soon after, his legacy preserved.

In this compelling recording, multiple case studies like Harold's will provide you with examples that you can incorporate when caring for the terminally ill. Caring for patients with end stage disease requires extreme sensitivity, deep compassion, and extraordinary knowledge. In order to deliver expert, holistic care, healthcare professionals need to have a toolbox full of new interventions to promote quality of life.

Each particular end stage disease has unique complexities for the patient, the family, and the healthcare professional - and this recording will cover specific strategies for caring for these patients.

Did you know that a patient seeking a liver transplant can be on hospice care while waiting? We will discuss how this is done.

What can we do for patients with COPD who's seemingly only solution for an exacerbation is a visit to the ER? We have an intervention for this.

How can we keep costs down without sacrificing patient care? We’ll give you the latest strategies, proven successful in practice.

It's time to think outside the box.

Walk away from this recording with new tools for quality support - and care when there is no cure.

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

Module Five | Care When There is No Cure for Patients with End Stage Diseases

Copyright : 11/30/2018

Module Six | Care When There is No Cure for Patients with End Stage Diseases

Copyright : 11/30/2018

Module Seven | Palliative Wound Care: Management of Complex and Unique Wound Challenges at the End of Life

Solutions to your biggest challenges with complex wounds, fungating wounds, fistulas and chronic painful wounds
Dramatically increase your confidence in treating your patients’ wound pain
Differentiate between avoidable and unavoidable wounds
Documentation strategies to decrease your professional risks
Hands-on practice for various wound dressing types, aromatherapy samples, and topical homeopathic treatment options for wound care
Bonus Session: Learn how to prevent burnout, compassion fatigue and develop a personalized plan of self-care to increase your resiliency

Do you ever feel helpless and frustrated in caring for patients at end of life who suffer from horrific, unavoidable wounds? Have you ever been told there is nothing else you can do for a patient who is at end of life? That simply is NOT true! Maintaining hope, comfort and dignity is by far one of the most important things we can do for our patients in relieving their suffering. Wounds caused by cancer, vascular insufficiency or skin failure are overwhelming for patients and caregivers. This seminar will provide an in-depth approach to palliative wound care, exploring options to care for patients with chronic wounds, fistulas, fungating wounds and terminal Kennedy ulcers. You will become prepared to care for those patients suffering from challenging wounds at end of life with confidence, compassion and knowledge.

Wound pictures from actual patients will be shared and case studies will be discussed to drive home important points. You will learn based on the different etiologies and presentations, how to choose the best dressing, when debridement is appropriate and formulary creation that will be helpful to your organization. There will be “hands-on” opportunities to test out the different types of wound care dressings available, as well as the latest alternative homeopathic treatment options. This in-depth seminar is “useable” information that you can easily apply in caring for your most complex wound patients and quickly allows you to become a valuable resource for your team.

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

Module Eight | Palliative Wound Care: Management of Complex and Unique Wound Challenges at the End of Life

Copyright : 03/23/2018

Module Nine | Palliative Wound Care: Management of Complex and Unique Wound Challenges at the End of Life

Copyright : 03/23/2018

Module Ten | Palliative Wound Care: Management of Complex and Unique Wound Challenges at the End of Life

Copyright : 03/23/2018

BONUS | Understanding the Needs of the Dying: Bringing Hope, Comfort and Love to Life's Final Chapter

Featuring David Kessler

Renowned End-of-Life Expert, Author Featured on “Dr. Oz”, “Oprah & Friends”, CNN, NBC, MSNBC, PBS, People Magazine, “Entertainment Tonight”, The Wall Street Journal, The New York Times, Los Angeles Times

David Kessler, best-selling author, collaborator with the legendary Elisabeth Kübler-Ross, and well-known expert on palliative care, hospice and end-of-life issues will provide you the newest information on death, grief and deathbed phenomena … real, tested, engaging information you will not find anywhere else.

Delve deeper into the mysteries of life and death exploring key topics

New studies on deathbed visions, and the role they play in end-of-life care
Tools for sensitivity and discretion for balancing wishes of the dying and family with medical, ethical and legal considerations
Communication strategies for necessary difficult and emotion conversations
Deeper insight on how anticipatory grief shapes end-of-life experiences
Understand why children are often the forgotten grievers, and how to help
Cultural differences and new sensitivity to care
Assisted suicide

It’s guaranteed to be a seminar that will enhance your work as a caregiver and David will provide so much insight, tools, strategies and inspiring information, you’ll look forward to the next day at your work … so you can immediately begin to use all you have learned.

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

BONUS | David Kessler: Finding Meaning: The Sixth Stage of Grief

Even as a grief expert, David was unprepared for the sudden death of his son, who died at age 21. People asked him, “What’s it like for the grief expert to lose his son?” He would answer, “The grief expert did not lose his son, the father did.” Everything he knew about grief turned out to be true. David had to go through the five stages of grief but found himself left wanting more from the experience – he wanted to find meaning in his life after such a terrible loss. He learned that broken heart syndrome is real and he realized he would either die of it or live with it, and that healing occurs not when grief gets smaller, but when life gets bigger. This led to the discovery of the 6th stage of grief – finding meaning.

Based on David Kessler’s newest book, Finding Meaning: The Sixth Stage of Grief, this seminar recording is designed to help professionals guide people through life’s worst moments to find meaning after loss. All types of loss will be covered, including betrayal, loss of a parent or family member, and loss due to addiction, mental illness and suicide.

After attending this seminar recording, you will be able to enhance your work with those who have dealt with any kind of loss. It will fill you with new insight, tools, strategies, and inspiring information, leaving you looking forward to the next day… so you can immediately begin to use all you have learned!

Don't miss this opportunity to learn from one of the world's leading grief experts - purchase today!

“People always want to know if there is life after death for their loved ones. I believe there is, but more importantly, there is life after death for the living. I want to help them find meaning that honors their loved ones. Sometimes when we are at our worst, we can find our best.” -David Kessler

David is honored to have received permission from The Elisabeth Kübler-Ross Family and The Elisabeth Kübler-Ross Foundation to add a sixth stage to her renowned 5 stages 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