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Clinical Care (11)
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Pain is a very frequent symptom for patients at the end of life. Unlike many other symptoms, pain is a very subjective experience which a healthcare professional needs to learn about from the patient before an optimal treatment plan can be developed. To learn about another person’s pain, a two-way dialogue needs to take place. This session will assist either the healthcare professional or the lay person to learn the language of pain.
Upon successful completion of this session, participants will be able to:- To identify the barriers to adequate pain relief.
- To define key terms related to pain management.
- To list the components of a thorough pain assessment.
Patients commonly stop eating and drinking at the end of life because the needs of the body are changing. Decisions about whether to withhold or withdraw artificial hydration or nutrition for a terminally ill person can be very challenging.
Upon successful completion of this session, participants will be able to:- Identify three myths about eating and drinking at the end of life.
- Describe the benefits of dehydration at the end of life.
- List interventions to provide comfort for the patient experiencing anorexia and dehydration.
There are several ways to insure that your healthcare wishes are respected when you are no longer able to speak for yourself. In this session, we will explore many of the commonly used advance directives, and the importance of each one. This will include the power of Attorney for Healthcare, Living Will, and the newest advance directive, “Five Wishes.” Case samples will be included to illustrate the merits of advance directives as well as the dangers of not having one.
Upon successful completion of this session, participants will be able to:- Define the term advance directive.
- Discuss the difference between a power of Attorney for Healthcare and a Living Will.
- Explain what the Five Wishes document is and how it is different than other advance directives.
- Describe the importance of having an advance directive and what can happen without one.
This session is meant to guide you in telling your life story – not only an autobiography, but also a reflection on your life, through the use of an ethical will. An ethical will is a special kind of will that is not a legal document. It is a personal statement which provides a legacy of personal and spiritual values, hopes, experiences, love and forgiveness to family members and future generations. It originated in Jewish tradition and is gaining popularity with people of all faith traditions.
This course can be the beginning of a heartfelt message which will be treasured by all who read it. Writing an ethical will can be a healthy, healing exercise. It can help clarify your values and put life into perspective. It has been said that the ethical will provides a “glimpse into the soul of the author.”
Upon successful completion of this session, participants will be able to:- Identify personal and spiritual values and hopes and blessings for future generations.
- Develop a “life’s lessons” section.
- Affirm the past and be positive about the future.
- Write an Ethical Will.
Ethical issues are inherent in care provided to patients and families facing the end of life. professional codes and standards serve to facilitate resolution of ethical dilemmas. Healthcare professionals, individually and collectively, serve as advocates for ethical and legal practice at the end of life.
Upon successful completion of this session, participants will be able to:- Define the role of the healthcare professional in supporting ethical practice in end-of-life care.
- Explain ethical issues and dilemmas that may arise in end-of-life care.
- Describe advance directives and their role in preventing ethical dilemmas.
- Apply ethical principles utilized in addressing end-of-life dilemmas.
This session will focus on the collaborative role of the hospice social worker. It will explore ways of utilizing both a team and community intervention perspective to assist patients and families where home is the long-term care setting. This session will also address ways of responding to the long term care staff as quasi-extended family.
Upon successful completion of this session, participants will be able to:- Describe the role of the hospice social worker in long term care.
- Identify ways of utilizing a team and community intervention perspective to provide comprehensive end-of-life care.
- Demonstrate an ability to design a strategy for implementing this model into one’s clinical practice.
The actual time of death is a critical event in the trajectory of illness; preparation is necessary to insure the provision of the best care. Care at this time demands attention to physical, psychological, social and spiritual needs of patients and families. Assessment by professionals of their own experiences at the time of death is helpful to strengthen professional effectiveness.
Upon successful completion of this session, participants will be able to:- Assess an imminently dying patient and list five physical signs and symptoms of the dying process and three signs of death.
- Assess physical,psychological, social and spiritual care needs and interventions for an imminently dying patient and his/her family.
- Identify personal experiences with death and describe how the healthcare professional can access support in caring for the dying patient and his/her family.
This session will address both the richness and the complexity of working on an interdisciplinary team. It will highlight the necessity and implications of healthy boundaries with clients as well as with other team members. The emphasis will be on the impact of this perspective for developing clinical practice that is sensitive to individual needs and differences.
Upon successful completion of this session, participants will be able to:- Describe the unique dimension of working on an interdisciplinary team.
- Identify healthy boundaries that meet client needs while maintaining clinical perspectives.
- Demonstrate a working knowledge of ways of integrating the concepts presented into clinical practice in end-of-life care.
This experiential session will explore principles of cultural competence and their application to end-of-life care. The focus will be on ways for professionals to identify their own cultural framework and how this interacts with the cultural framework of patients/families. There will also be an opportunity to explore a model for increasing one’s cultural awareness and sensitivity especially in relation to end-of-life care issues.
Upon successful completion of this session, participants will be able to:- Describe the principles of cultural competence.
- Identify cultural influences pertaining to end-of-life care.
- Demonstrate a beginning skill level in utilizing a model for achieving cultural competence.
This session will discuss the process of a structured life review and its role in facilitating end-of-life work for the patient/family. This process promotes the telling and re-telling of one’s story as a way of finding and sharing meaning. It highlights the uniqueness of the person and also provides an avenue for creating a legacy for the family. Specific guidelines and techniques will be reviewed.
Upon successful completion of this session, participants will be able to:- Describe the life review process and its value for end-of-life care.
- Identify themes and common threads for weaving meaning into the life story.
- Demonstrate a beginning skill level for facilitating a structured life review.
This experiential session will discuss the essential role of the spiritual dimension in end-of-life care from a social work perspective. The difference between spirituality and religion will be addressed. Ways of integrating these principles into one’s clinical practice will also be explored.
Upon successful completion of this session, participants will be able to:- Describe the difference between religion and spirituality.
- Identify specific themes denoting the spiritual dimension of end-of-life care.
- Demonstrate a beginning skill set for integrating the spiritual perspective into one’s clinical practice.
Participants will learn about the physical, psychological and spiritual benefits of music for relaxation. Music relaxation strategies that are specifically designed for caregivers will be offered and practiced, including music-facilitated relaxation which pairs live, relaxing harp music with directions for muscle relaxation – a full body massage with music! Suggestions for using music at home for self-care will also be covered.
Upon successful completion of this session, participants will be able to:- Identify the physical, psychological and spiritual effects of music on the body.
- Identify strategies that utilize music which are helpful for reducing stress.
- Recognize the effects of relaxing music on health through participation in music-facilitated relaxation.
- Discuss techniques designed specifically for caregivers to use music for relaxation at home.
This session will examine the family’s experience in end-of-life care. A family systems perspective will be used to define ways of assessing, intervening and empowering the family to change, adapt and accommodate both to the losses and to the opportunities for growth in this process.
Upon successful completion of this session, participants will be able to:- Describe the ways of assessing family dynamics from a strengths perspective regarding end-of-life care issues.
- Identify the opportunities for empowering and coaching the family to provide a legacy for the family system.
- Demonstrate a working knowledge of the impact of the care giving role and its differential impact on the family when the process of dying is prolonged.
This session will discuss and explore the suicide risks involved in end-of-life care. Societal and clinical responses will be examined. The focus will be on assessment, intervention and implementation of practice guidelines for the clinician.
Upon successful completion of this session, participants will be able to:- Describe assessment tools and cognitive and behavioral intervention strategies for use with suicidal patients.
- Identify the relationship between depression and suicide.
- Demonstrate a working knowledge of depression treatment options.
During most medical care, the implicit goal is to cure or modify the progression of the medical malady. In chronic progressive disease conditions, the achievable goal increasingly becomes one of primarily providing relief of symptoms. This session will identify the nature of these different goals and explore ways to conduct the conversation to allow patients to select the balance most consistent with their understanding and their value system.
Upon successful completion of this session, participants will be able to:- Compare and contrast the treatment goals of curative/disease modifying care and comfort/palliative care.
- Understand the role of the patient’s own values in determining the balance between curative and palliative goals.
- Review ways in which to guide the discussion with patients/families to identify appropriate goals of care.
This session will provide an experiential exploration of ways to communicate with patients/families at an intensely meaningful time. It will address specific ways of responding to questions about the end of life, death and dying. The concept of person-centered care vs. task-centered care will be explored. Also, there will be a discussion of how “to be present” as a professional when the tasks move into the realm of the spiritual dimension of the dying process.
Upon successful completion of this session, participants will be able to:- Demonstrate communication skills for responding to end-of-life questions.
- Identify ways of “being present” in a compassionate way.
- Demonstrate a basic understanding of moving from task-centered care to person-centered care.
This session will address specific ways for clinicians to set goals and define their role in the delivery of end-of-life care. It will explore both clinical perspectives as well as ways to translate one’s role to patients/families, to other team members and to the larger community of healthcare providers. The areas of accountability, professional identity and professional ethics will be addressed.
Upon successful completion of this session, participants will be able to:- Describe the role of hospice social work in end-of-life care.
- Identify goals, interventions and outcomes for social work practice.
- Demonstrate a beginning ability to translate clinical decisions into accountable practice for end-of-life care.
This session will address ways to empower the family to respond to children who are facing the death of a loved one. A discussion of child-centered and family-focused interventions will be included as well as an exploration of various options for assisting the family. Both goals and practical, age-specific interventions will be highlighted. The importance of assisting the child in a family context will be delineated.
Upon successful completion of this session, participants will be able to:- Describe ways to empower the family in caring for children facing the death of a loved one.
- Identify specific needs for children facing the death of a loved one.
- Demonstrate a beginning understanding of the goals and specific interventions to assist children and their families facing the death of a loved one.
This session will review essential elements for a comprehensive psychosocial assessment. It will include various instruments and tools used to assess the core competencies for safe and comfortable dying, client self-determination and effective grieving. The emphasis will include assessment skills for both the dying person and his/her family.
Upon successful completion of this session, participants will be able to:- Describe the basic elements of a comprehensive psychosocial assessment.
- Identify key variables that impact the core competencies in end-of-life care.
- Demonstrate a working knowledge of how to apply these tools for both initial and on-going assessments.
Unless patients understand the nature of their illnesses and conditions, they cannot make informed decisions. Using a model developed by the Education for physicians on End-of-life Care program, this session explains a simple six-step approach for physicians and other caregivers to create the setting and context for this necessary dialogue.
Upon successful completion of this session, participants will be able to:- Identify the importance and challenge of sharing bad news with patients and families.
- Describe an effective six-step approach to communicating bad news.
- Apply the principles of the six-step approach to an actual case scenario.
This informative course reveals how and why music brings us to tears, relaxes us, and even makes us more resistant to disease. Through participation in interactive musical experiences, group discussion and readings, participants will gain knowledge about music and its effectiveness to mind, body and spirit. The field of music therapy and its effectiveness with patients of all ages, needs and abilities will also be discussed.
Upon successful completion of this session, participants will be able to:- Identify how music affects us physically, emotionally and spiritually.
- Identify why music is effective for alleviating pain and stress.
- Recognize the effects of relaxing music on health through participation in music facilitated relaxation using live harp music.
- Define music therapy and describe its role as a recognized health care profession.
- Apply knowledge about the effects of music to a variety of health care populations.
Grief impacts our physical, psychological and spiritual well-being. The grief that follows a significant loss, such as the death of a family member, friend or co-worker, will impact one’s ability to do his/her job effectively. This session will identify ways that the workplace can be supportive and helpful to a grieving individual.
Upon successful completion of this session, participants will be able to:- Describe the impact of grief, loss and survivor guilt.
- Recognize the factors influencing individual’s responses.
- Describe the elements of a supportive working environment.
- Identify resources for bereaved employees.
Because they offer a system of shared values, common images of hope and meaning and a gathering of caring people, faith communities provide an ideal context in which to talk about death, acknowledge loss and celebrate life. Yet, even within the “safe” confines of the church or temple, it is often difficult to initiate these conversations. How do we create the right climate in our communities for celebrating life and acknowledging loss?
Upon successful completion of this session, participants will be able to:- Describe the faith community’s theological resources for conversations about life and loss.
- Identify the faith community’s current programming for addressing end-of-life issues and concerns.
- Demonstrate a plan that invites members of the faith community into a conversation about life, death and loss.
"Tragedies inherently contain elements that lead to complicated mourning. public tragedy refers to a calamitous event that brings death to one or more people and arouses great grief and oftentimes horror in its social audience” (Therese Rando, 2003). When a tragedy is public, communities gather in response. This session will illustrate how the main goals after a public tragedy (survival, reorganization and reestablishment) can become a guiding force in the community response.
Upon successful completion of this session, participants will be able to:- Identify the myriad of responses to untimely, sudden and public traumatic deaths.
- Recognize the identification or detachment that occurs when community members respond.
- Describe ways of providing support in the short and long term.
Working with people experiencing loss and grief is personal and emotional work. A worker’s response to each loss is individual just as each relationship is unique. When people experience grief in succession it is difficult to separate and identify how it impacts them. Unresolved cumulative loss can lead to burnout and feelings of anxiety. This session will identify symptoms of compassion fatigue and suggest ways to positively deal with the emotions involved.
Upon successful completion of this session, participants will be able to:- Recognize the effects of cumulative loss.
- Identify techniques for understanding the impact that death can have for one personally and professionally.
- Describe methods of self-care when coping with multiple losses.
Spiritual care at the end of life is the art of listening to, seeking to understand and affirming the spiritual traditions and religious roots of those who are living with a terminal illness. Those who face loss and the end of life draw upon the resources developed over the course of a lifetime that have provided them with meaning and hope in previous times of crisis. Spiritual care is most effective when it enables those served to connect with those resources.
Upon successful completion of this session, participants will be able to:- Describe the relationship between spirituality and religion.
- Identify universal spiritual issues faced at end of life.
- Demonstrate an awareness of one’s own spiritual resources.
Providing care for a friend or loved one who is living with a chronic or terminal illness is perhaps the most challenging responsibility one can accept. The demands of caregiving can be physically, emotionally, financially and spiritually exhausting. Caregivers often find it difficult to care for and nurture themselves at the same time.
Upon successful completion of this session, participants will be able to:- Describe the relationship between spirituality and religion.
- Identify one’s own spiritual resources and sources of spiritual renewal.
- Demonstrate an ability to reflect upon one’s caregiving responsibilities in the context of one’s spiritual life and religious traditions.
Through the mourning process a person assimilates the death of a loved one into his/her life experience. This is a process that requires active involvement. This session will identify techniques and experiences that can help people to regain hope and happiness.
Upon successful completion of this session, participants will be able to:- Recognize individual mourning styles.
- Define Worden’s task-based mourning process for adults.
- Define and recognize complicated mourning.
Participants will learn about the field of music therapy and its role in healthcare. Through case studies and experiential activities, individuals will increase their understanding of the many ways in which music therapy can help hospice patients and families. Suggestions for using music at the bedside will be offered.
Upon successful completion of this session, participants will be able to:- Define music therapy and describe its role as a recognized health care profession.
- Identify the physiological effects of music on the body.
- Identify the physical, psychological and spiritual effects of music therapy with hospice patients and families.
- Integrate knowledge of music therapy through observation or participation in fun and meaningful music therapy interventions.
Relationships are the core of our support networks. There are many significant relationships and losses that greatly impact our lives and yet are not formally recognized by society. As a result, the griever is not recognized and does not receive much-needed support. Some examples include loss of an ex-spouse, an Alzheimer’s patient or a significant other in a non-conventional relationship. This session will address ways to recognize and respond to disenfranchised grief.
Upon successful completion of this session, participants will be able to:- Identify various categories of disenfranchised grievers.
- Recognize and respond to hidden grief.
This session will explore the changes in our culture and in health care delivery which affect end-of-life care. It will distinguish some of the commonalities and differences in various types of advance directives, i.e. Durable power of Attorney for Health Care, Living Will and Five Wishes. The emphasis will be on practical ways to facilitate a discussion about advance care planning and to assist patients/families to identify their options.
Upon successful completion of this session, participants will be able to:- Describe the various types of Advance Directives.
- Identify cultural, societal and belief system factors related to end-of-life care choices.
- Demonstrate practical skills for facilitating end-of-life care discussions for patients/families.
Working with grieving children and their families presents a real, and often difficult, challenge. It is also true that the grief children are feeling comes into the classroom with them. This session will present how participants can respond to these children and their families with the compassion, competence and confidence that will provide the very best kind of help.
Upon successful completion of this session, participants will be able to:- Recognize anticipatory grief reactions in a child.
- Describe the effect of grief on a child’s learning and behavior at each developmental level.
- Identify elements of a helpful school/classroom response.
- Cite the age appropriate learning objectives and methods for death education in a value-based curriculum.
- Respond to grieving children and their parents in an appropriate, compassionate manner.
As people grow older, many of them are challenged to deal with loss in a myriad of ways including loss of health, independence and energy. In addition, support networks and families age and are facing similar This session will highlight ways to cope and even thrive when loss becomes a part of daily life.
Upon successful completion of this session, participants will be able to:- Recognize the effect that loss and death have upon our lives.
- Describe the “HUG” acronym for successful aging.
- Recognize the role of forgiveness in loss and aging.
This session will address the personal and professional awareness of the emotional impact of doing end-of-life work. Tools for assessing loss will be explored. The issues of balancing the compassionate response and the professional response will be addressed. Specific strategies for expanding knowledge, skill and self-care will be discussed.
Upon successful completion of this session, participants will be able to:- Describe the parallel process of being a professional in an intensely human experience.
- Identify ways to be compassionately present.
- Demonstrate a beginning knowledge of skills for promoting excellence in end-of-life care while balancing self-care.
Hospice is an option in end-of-life care that can be delivered in a variety of settings. It is a philosophy, a way of caring for individuals living with serious illness who no longer benefit from curative treatments. When the time comes that a cure is no longer probable, hospice embraces the patient and their family as they focus on comfort and the end of life.
Upon successful completion of this session, participants will be able to:- Describe the hospice concept and philosophy of care.
- List the services provided by hospice.
- Identify the payer sources for hospice care.
- Identify the criteria for hospice admission.
Whether a person is 80 years old or 30 years old when his or her child dies, it shakes one’s reality. Feelings of vulnerability and anger as well as questions of faith are often posed to the professionals whom bereaved parents encounter. This session will address ways professionals can prepare for working with bereaved parents during all phases of their grief journey.
Upon successful completion of this session, participants will be able to:- Describe the parameters for realistic grief expectations for bereaved parents.
- Recognize the impact of the loss-specific issues related to the age of the child and the current relationship of the parent and child.
- Describe techniques of self-care when working with bereaved parents.
- Respond respectfully to bereaved parents of all ages.
The death of a significant person in one’s life is one of the most painful stressors and can have life long ramifications. Adults presumably have sufficient coping mechanisms and emotional and cognitive maturity to deal with death. Children, on the other hand, have less adequate coping skills and are continually faced with reprocessing their grief at various developmental stages of their lives. This session will address grief reactions of children at various developmental stages and describe appropriate responses.
Upon successful completion of this session, participants will be able to:- Describe normal grief reactions and the indicators of complicated grief in children.
- Identify the elements of an appropriate response for children.
- Differentiate the impact of a death at each developmental level.
This session will explore the specific relationship issues generated by the death of a parent. Whether the death is sudden or anticipated, it calls one to examine the sense of legacy, who is family now and ways of coping with both the feelings and tasks of mourning.
Upon successful completion of this session, participants will be able to:- Recognize the complexity of relationship issues connected to the death of a parent.
- Describe the tasks of mourning.
- Identify the tools for coping with both the feelings and the tasks of mourning.
Welcome to the Rainbow LIFE Institute online education portal. To view a list of available online courses please see the course catalog below.
If you would like to request a presentation based on any of the available courses or have additional information about courses, registration, CE credits or the LIFE Institute, please call 847-292-2012.
To return to the Rainbow Hospice and Palliative Care Homepage, please click here.
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