Training Module -- End of Life Care

Long-Term Care Intensive Train-the-Trainer Series on
End-of-Life Care

Funded by the Michigan Department of Community Health Long-Term Care Initiative, the Wayne State University Institute of Gerontology, in partnership with Hospice of Michigan and Lutheran Social Services of Michigan, has developed a series of training modules on end-of-life care.

The training modules consist of Microsoft Powerpoint slide shows for presentation and Microsoft Word documents for printing. Those interested in obtaining the End-of-Life Care training modules may fill out and submit the online application form to request copies, which will be sent free of charge via e-mail to educators.

There are six modules in the series:

Historical Perspectives of Dying and Death in America – Attitudes toward dying and death in have evolved throughout our history. Early settlers brought to their values, customs, and beliefs regarding death and dying. Ever developing social and scientific ideas continued to shape these beliefs forming our current perceptions of death and how each of us wants to die. This module traces some of the significant historical events influencing hospice care. In addition it provides an introduction to the concepts of hospice and palliative care as practiced in a variety of settings today including long term care.

Ethical and Legal Concerns – Advances in medical technology, changes in social and family systems, the advent of managed care, and an unlimited array of healthcare choices have added to the complexity of end of life care. Ethical dilemmas on macro and micro levels emerge as the debate on extending life versus prolonging death continues.

Pain Management – Pain management is a primary care concern in the hospice setting. It is estimated that 40% of all persons admitted to hospice present with pain rated between 7 and 10 on a 0 - 10 numerical scale. Some research has indicated that at least 25% of all cancer patients die without adequate pain relief (AAHPM, 1196). An interdisciplinary approach should be considered as essential for comprehensive pain management.

Communication Skills at End-of-Life – Communication with a resident/family is a crucial requirement to success in palliative care. A terminal illness is a family experience. The role of communication includes sharing information as well as responding appropriately to resident issues and concerns. Communicating effectively may also help dispel preconceived notions/myths about illness or treatment. Communication also involves strong collaboration between members of the health care team especially when the need is to reinforce bad news.

Imminent Death – This module will focus on these and other issues as related to the use of communication skills at end-of-life.This module provides an overview of care requirements at the time death including physical, psychological and spiritual care of the patient as well as support of family members. Emphasis will also be placed on the death event, recognizing death, and after death care.

Grief, Loss, and Bereavement – Loss, grief, and bereavement affect resident, family, and staff. Each survivor and health care professional experiences grief in his or her own way, with his or her own coping skills, in accordance with his or her own cultural norms, belief systems, faith systems, and life experiences.

Wayne State University Institute of Gerontology, Hospice of Michigan, and Lutheran Social Services of Michigan would like to acknowledge the End-of-Life Nursing Education Consortium (ELNEC) Project of American Association of Colleges of Nursing for their educational contribution in the design and development of this material.

For more information about the End-of-Life training modules, or to suggest additions to the end-of-life resources page, please e-mail Dr. Jennifer Mendez at jmendez@wayne.edu.