David Kessler – Understanding the Needs of the Dying: Bringing Hope, Comfort and Love to Life’s Final Chapter

Outline

Signs of Impending DeathSigns of Impending Death

• Preparing family for physical changesPreparing family for physical changes
• Interventions for coping with emotional changes in the familyInterventions for coping with emotional changes in the family
• Using near death awareness as a predictor in clinical settingsUsing near death awareness as a predictor in clinical settings

Palliative Care ModelPalliative Care Model

• Academic settings vs communityAcademic settings vs community
• Physician led vs non physician ledPhysician led vs non physician led
• Roles of physician, nurse, social worker, case manager, discharge planner, clergyRoles of physician, nurse, social worker, case manager, discharge planner, clergy
• What’s best – hospital, home health, hospice, skilled nursing facilityWhat’s best – hospital, home health, hospice, skilled nursing facility
• Joint commission certificationJoint commission certification

HospiceHospice

• Removing barriersRemoving barriers
• How hospice can increase length of stay while decreasing hospital timeHow hospice can increase length of stay while decreasing hospital time
• Bereavement services to enhance community partnershipsBereavement services to enhance community partnerships

Death Related Sensory Experiences (Death Bed Visions)Death Related Sensory Experiences (Death Bed Visions)

• Effective and ineffective models for family coping and integrationEffective and ineffective models for family coping and integration
• Religion in patients’ deathbed visionsReligion in patients’ deathbed visions
• Using the law to normalize the dying experienceUsing the law to normalize the dying experience
• Clinical/palliative care studies, research of near death awarenessClinical/palliative care studies, research of near death awareness

Advance DirectivesAdvance Directives

• Physician order for life-sustaining treatmentPhysician order for life-sustaining treatment
• Make advance directives useful and medically effectiveMake advance directives useful and medically effective
• D.N.R. (do not resuscitate) vs. A.N.D. (allow natural death)D.N.R. (do not resuscitate) vs. A.N.D. (allow natural death)
• Code status and impact on the grieving processCode status and impact on the grieving process

Anticipatory GriefAnticipatory Grief

• Treatment strategies for hospice, palliative care and mental health care professionalsTreatment strategies for hospice, palliative care and mental health care professionals
• Tools for normalizingTools for normalizing

Helping the Dying Patient’s ChildrenHelping the Dying Patient’s Children

• How the media shapes a child’s view of deathHow the media shapes a child’s view of death
• Tools for preparing a child for lossTools for preparing a child for loss
• Interventions for coping with funeralsInterventions for coping with funerals
• Why children are often the forgotten grievers and how to helpWhy children are often the forgotten grievers and how to help

The Ethics Committee and End of LifeThe Ethics Committee and End of Life

• How and when to use your ethics committeeHow and when to use your ethics committee
• How and why members of the end of life team can participateHow and why members of the end of life team can participate
• Techniques for helping families get the most out of the ethics meetingsTechniques for helping families get the most out of the ethics meetings
• Avoid the common pitfalls of ethics committees at the end of lifeAvoid the common pitfalls of ethics committees at the end of life

Hope and MiraclesHope and Miracles

• How to help families integrate desire for miracles at the end of lifeHow to help families integrate desire for miracles at the end of life
• Techniques for honoring hope without fostering denialTechniques for honoring hope without fostering denial

Cultural DifferencesCultural Differences

• Affecting care of the dyingAffecting care of the dying
• Tools for successfully bridging the gap with healthcare providers and familiesTools for successfully bridging the gap with healthcare providers and families

The Question of Assisted SuicideThe Question of Assisted Suicide

• Understanding the current debateUnderstanding the current debate
• The realities of withdrawing care vs. assisted suicideThe 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 systemLearn techniques for addressing patient’s requests for assisted suicide within the facilities and health care provider’s beliefs system