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

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