Full Course Description

End Stage Diseases: Care When There Is No Cure

OUTLINE

Disease Prognostication: An Inexact Art & Science

Illness and Dying Trajectory
Performance Scales
Prognosis Tools
Determining Palliative Care vs. Hospice
National Consensus Project: Eight Domains for Quality Practice
Crucial Conversations

Heart Failure

Stages
Treatment options
Devices to Extend Life
Symptom Burden/Management
Prognostic Models
Living better - or prolonging suffering?

Advanced Cancer/ Neoplastic conditions

Staging Cancer
Spiritual needs
Complications and interventions
- Spinal cord compression
- Superior vena cava syndrome
- Bowel obstruction
- Hypercalcemia
- Fungating wound care
- Signs of impending death

Pulmonary Disease

Staging the disease
Spirometry: a required test
The MMRC Breathlessness Scale
Treating dyspnea: The pain of non-malignant disease
The medical toolbox: oxygen, bronchodilators, opioids & steroids

Amyotrophic Lateral Sclerosis

Diagnostic tests
Post-polio syndrome: An ALS mimic
Advance directives and life support decisions: nutrition & gastrostomy, non-invasive ventilation or invasive?
Table of useful medications

Advanced Dementia

Stages
Ethical issues: feeding, medications
Ensuring comfort
Delirium & dementia
Interventions for agitation and aggression

Renal Disease

Appropriate use of dialysis
Staging disease with Glomerular Filtration Rate (GFR)
Hemodialysis mortality predictor
Symptom burden
Underutilization of hospice

Liver Disease

Prognostic Determination
Ethical issues
Signs of ‘end stage’

Challenging Decisions

What do People Want at the End of Life?
Honoring Patients Wishes
Delirium vs near death experience
Dying Signs, symptoms and needs - is hydration needed?
Mental health needs of the dying
Managing pain as death nears
Palliative sedation therapy: for intractable symptoms

Moral Distress

Ethical dilemmas
Medication errors
Conflicted consciences
Giving the last dose
Attending the first death
Strategies for diminishing death discomfort
Personal versus professional grieving

OBJECTIVES

Evaluate two performance and prognostic methods that are predictive of poor survival.
Compare palliative care services to hospice care.
Differentiate unique palliative care interventions for the complexities of five end stage diseases.
Identify two ethical issues often seen in end stage disease.
Specify three challenges faced at the end of life.
Recognize two strategies to overcome fear of death and moral distress.

Program Information

Outline

Disease Prognostication: An Inexact Art & Science

Illness and Dying Trajectory
Performance Scales
Prognosis Tools
Determining Palliative Care vs. Hospice
National Consensus Project: Eight Domains for Quality Practice
Crucial Conversations

Heart Failure

Stages
Treatment options
Devices to Extend Life
Symptom Burden/Management
Prognostic Models
Living better - or prolonging suffering?

Advanced Cancer/ Neoplastic conditions

Staging Cancer
Spiritual needs
Complications and interventions
- Spinal cord compression
- Superior vena cava syndrome
- Bowel obstruction
- Hypercalcemia
- Fungating wound care
- Signs of impending death

Pulmonary Disease

Staging the disease
Spirometry: a required test
The MMRC Breathlessness Scale
Treating dyspnea: The pain of non-malignant disease
The medical toolbox: oxygen, bronchodilators, opioids & steroids

Amyotrophic Lateral Sclerosis

Diagnostic tests
Post-polio syndrome: An ALS mimic
Advance directives and life support decisions: nutrition & gastrostomy, non-invasive ventilation or invasive?
Table of useful medications

Advanced Dementia

Stages
Ethical issues: feeding, medications
Ensuring comfort
Delirium & dementia
Interventions for agitation and aggression

Renal Disease

Appropriate use of dialysis
Staging disease with Glomerular Filtration Rate (GFR)
Hemodialysis mortality predictor
Symptom burden
Underutilization of hospice

Liver Disease

Prognostic Determination
Ethical issues
Signs of ‘end stage’

Challenging Decisions

What do People Want at the End of Life?
Honoring Patients Wishes
Delirium vs near death experience
Dying Signs, symptoms and needs - is hydration needed?
Mental health needs of the dying
Managing pain as death nears
Palliative sedation therapy: for intractable symptoms

Moral Distress

Ethical dilemmas
Medication errors
Conflicted consciences
Giving the last dose
Attending the first death
Strategies for diminishing death discomfort
Personal versus professional grieving

Objectives

Evaluate two performance and prognostic methods that are predictive of poor survival.
Compare palliative care services to hospice care.
Differentiate unique palliative care interventions for the complexities of five end stage diseases.
Identify two ethical issues often seen in end stage disease.
Specify three challenges faced at the end of life.
Recognize two strategies to overcome fear of death and moral distress.

Target Audience

Case Managers, Chaplains/Clergy, Counselors, Nurses, Social Workers

Copyright : 10/07/2016

Accompanying the Dying Patient: End of Life Care

OUTLINE

The Patient at End of Life

Palliative care vs. hospice care
Barriers to providing quality care at the end of life
Research that addresses death and dying

Family Communication at End of Life

Specific challenges addressed
Assessing goals of care
Communication strategies
Interdisciplinary approach
POLST/Advance directive documents
Examples of crucial conversations

Providing Holistic Care at End of Life

Cultural considerations
Grief and loss
Extent of symptoms
Impact on family
Type of disease and prior treatment success or failure
Legal/Ethical Issues

Symptom Management at End of Life

Pain
Dyspnea
Anorexia
Fatigue
Constipation
Nausea/Vomiting
Depression
Anxiety

Patient Outcomes

HCAHPS
Press Ganey
Nursing interventions that impact satisfaction scores
Performance improvement strategies
The Joint Commission Standards
Using MDS in long term care to capture pain management