Last Days of Life (PDQ) (2 credit hours)

Program Summary:  This course explores the last days of life; common end of life symptoms, treatments, and care considerations are examined.  Ethical perspectives and religious and spiritual beliefs are discussed along with decisions for withdrawing care and no further escalation of care.  This course is intended as a resource for oncology clinicians providing EOL care.

This course is recommended for social workers and appropriate for beginning and intermediate levels of practice.  This course is not recommended for NBCC ethics credit.

Find the reading at:  https://www.freestatesocialwork.com/articles/LastDaysofLifePDQ.pdf

Publisher:  The National Cancer Institute

Course Objectives: To enhance professional practice, values, skills, and knowledge by identifying key issues related to high-quality EOL care.

Learning Objectives:  Describe common end of life symptoms for patients.  Identify care decisions in the final weeks, days, and hours of life.  Identify barriers to hospice care.  Describe ethical perspectives including patient autonomy and the principle of double effect.

Review our pre-reading study guide.

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1: Patient recall of EOL discussions, spiritual care, or early palliative care are associated with
 
 
2: Which of the following is an 11-point scale describing a patient's level of ambulation, level of activity, evidence of disease, ability to perform self-care, nutritional intake, and level of consciousness?
 
 
 
 
3: Impending death, or actively dying, refers to the process in which patients who are expected to die within _________ exhibit a constellation of symptoms.
 
 
 
 
4: The ability to diagnose impending death with confidence is of utmost importance to clinicians because it could
 
 
 
 
5: The Investigating the Process of Dying study identified _______________ in the last weeks and days of life.
 
 
 
 
6: In the final days to hours of life, patients may have limited, transitory moments of lucidity-
 
 
7: Which of the following is a patient-completed measure of the severity of nine symptoms (anxiety, lack of appetite, depression, drowsiness, nausea, pain, shortness of breath, tiredness, and well-being)?
 
 
 
 
8: In dying patients, a poorly understood phenomenon that appears to be distinct from delirium is the experience of
 
 
 
 
9: The average intensity of pain often _____________ as patients approach the final days.
 
 
10: For patients who experience dysphagia in the last days of life, which of the following is usually recommended?
 
 
 
 
11: Which of the following describes death rattle?
 
 
 
 
12: Which of the following describes myoclonus?
 
 
 
 
13: What percent of patients with advanced cancer continue to receive chemotherapy toward the end of life?
 
 
 
 
14: Patients with advanced cancer who receive hospice care appear to experience
 
 
 
 
 
 
15: Which of the following was associated with short hospice stays?
 
 
 
 
16: The Medicare hospice benefit requires that physicians certify patients' life expectancies shorter than 6 months and that patients forgo
 
 
 
 
 
17: In multivariable analysis, which of the following factors correlated with a lesser likelihood of dying at home?
 
 
 
 
18: Which of the following patients may be less likely to prefer to die at home?
 
 
 
 
19: A negative right to be free from the interference of others or, in health care, to refuse a recommended treatment or intervention best describes
 
 
 
 
20: There are limits to the principle of patient autonomy.
 
 
21: Which of the following is a consideration for artificial nutrition at the end of life?
 
 
 
 
22: Which of the following describes the strategy of no further escalation of care?
 
 
 
23: A number of studies have reported strong _____________ between patients' and caregivers' emotional states.
 
 
24: The use of palliative sedation for ______________ is highly controversial.
 
 
25: Which ethical principle states that the intended effect may justify the foreseeable but unintended consequence if the intended (positive) outcome is of greater value than the unintended (negative) outcome.
 
 
 
 
26: The intent of palliative sedation is
 
 
27: Reasons for requests for hastened death are multiple and complex and include which of the following:
 
 
 
 
 

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Free State Social Work, LLC, provider #1235, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Free State Social Work, LLC maintains responsibility for this course. ACE provider approval period: 9/6/2018 - 9/6/2021. Social workers completing this course receive 2 continuing education credits.

Free State Social Work has been approved by NBCC as an Approved Continuing Education Provider, ACEP NO. 6605. Programs that do not qualify for NBCC credit are clearly identified. Free State Social Work is solely responsible for all aspects of the programs.

G.M. Rydberg-Cox, MSW, LSCSW is the Continuing Education Director at Free State Social Work and responsible for the development of this course.  She received her Masters of Social Work in 1996 from the Jane Addams School of Social Work at the University of Illinois-Chicago and she has over 20 years of experience.  She has lived and worked as a social worker in Chicago, Boston, and Kansas City.  She currently practices in the area of hospital/medical social work.  The reading materials for this course were developed by another organization.