Clutter
& Hoarding AddictionArchive: educational programs
Rounding the Corner:
Integrating End-of-Life Care and Conversations with Services
November 12, 2008
This program will tackle the inevitable and important issue a professional must address: How to talk to older adults and their family members about death. What does a professional need to feel comfortable creating an effective dialogue about end-of-life issues? How will this change the care we provide? We will take a holistic approach that includes: interdisciplinary care, awareness of cultural issues and spiritual needs, chronic and advanced illness, caring for yourself and your clients, and grief and loss.
MORNING PLENARY SESSION — 8:30 AM TO NOON
Continuity of Care Issues at the End of Life
At a time where family and connection are crucial, we encounter a fractured healthcare system that is confusing and frustrating. Dr. Hallenbeck will discuss the challenges families face toward the end-of-life and offer suggestions for how best to navigate modern healthcare systems.
Keynote Speaker: James Hallenbeck, MD, Associate Chief of Staff for Extended Care and Director, Palliative Care Services, Stanford University and VA Palo Alto Health Care System; Associate Professor of Medicine, Division of General Internal Medicine, Stanford University
Three other panelists to address key thematic areas/perspectives:
Nursing and palliative care perspective
Dr. Hughes will discuss the nursing and long-term care implications of continuity of care at the end of life across a variety of care settings. She will identify the quality of care concerns that may occur with communication breakdowns about the plan of care among and between providers.
— Anne Hughes, RN, PhD, Advanced Practice Nurse, Palliative Care, Laguna Honda Hospital and Associate Clinical Professor of Nursing, School of Nursing, University of California San Francisco
Chinese American Coalition for Compassionate Care: Providing Life-Affirming Choices at End of Life
Recognized nationally and internationally, the Chinese American Coalition for Compassionate Care (CACCC) is the first nonprofit organization devoted to end-of-life issues for Chinese Americans. CACCC provides information, resources and materials in Chinese and in English; training for Chinese volunteers, patients, caregivers and the general public; training and instructions on advance care planning; training for health care providers on communication and cultural issues.
— Jeanne Wun, Community Relations Manager, Hospice of the Valley and Board Member and Chair-Elect, Chinese American Coalition for Compassionate Care
Spiritual Accompaniment at the End of Life
This presentation will focus on how to best accompany our clients through death and dying and offer simple interventions that address the spiritual issues commonly faced by dying people, as well as the triggers and transference that might come up for us as caregivers in approaching spiritual needs of the dying. Spiritual issues are not simply religious concerns, although spirituality and religion are connected.
— Rabbi Elliot Kukla, Bay Area Jewish Healing Center, Institute on Aging
LUNCHEON Keynote — NOON TO 1:00 PM
POLST: An Improved Process to Better Respect Patient Choices Near the End of Life
This presentation will introduce the audience to the POLST (Physician Orders at the End of Life) process for implementing medical orders about life sustaining procedures. The POLST process includes a carefully designed physician order page. POLST has been empowered by important new legislation in California. Dr. Mittelberger has been involved in end of life communication for over 20 years and serves as senior physician liaison to the California State POLST Task Force.
— James Mittelberger, MD, MPH, Western States Medical Director, Ovations/UnitedHealthcare and Clinical Professor of Medicine, University of California San Francisco
AFTERNOON WORKSHOPS — 1:00 TO 2:30 PM
1A. Helping Families to Work Together:
Family Dynamics at End of Life
In hospice and during final stages of diseases, the emphasis is often on the patient. However, the family and the informal caregivers are dealing with many issues of their own: return to family of origin, loss or change of roles, money, fairness, grief/loss, medical decisionmaking, etc. In this workshop, we will discuss what families are dealing with and ways that professionals can help them during this time.
— Donna Schempp, LCSW, Program Director, Family Caregiver Alliance
2A. Breaking Down Barriers to Better End-of-Life Care for Diverse Elders
The presenters will share through research and the use of case study and film new applications of cross-cultural competency.
Ms. Wun will focus on insights to Chinese American attitudes and practices about death, dying and grief gained through the work of the Chinese American Coalition for Compassionate Care and substantiated by research done by the National Hospice and Palliative Care Organization. She will also provide a case study for discussion learning. Dr. Williams, geriatrician, clinical medical ethicist and filmmaker, will look at FaSSI (Family, Struggles, Spirituality, Icons) as an approach to enhancing cross-cultural competency in end-of-life care. FASSI derives from work interviewing over 200 people for the RWJF funded documentary film "When We Are Asked". This film is the source material for the APPEAL Project trigger tapes. Clips from the cross-cultural sections of the film will be viewed to guide the workshop.
— September Williams, MD, Physician, Laguna Honda Hospital
— Jeanne Wun, Community Relations Manager, Hospice of the Valley and Member, Board of Directors, Chinese American Coalition for Compassionate Care
3A. Grief: Loss and Growth
Grief has been described as the study of people and their most intimate relationships: it is a multi-faceted response to loss comprising emotional, physical, social, cognitive and philosophical dimensions. This workshop will review some of the central theories of grief and some of the practice concepts they suggest/convey. Attention will be given to the broad and varied range of relationships of older adults.
— Brian deVries, PhD, Professor, Gerontology Programs, San Francisco State University
4A. Spiritual Needs at the End of Life
Humans are in part spiritual beings, and many people confronting their own or a loved one's mortality show increased focus on spiritual questions, concerns and contextualization of their experience. Across disciplines, professional caregivers who are listening for them can identify, assess, refer and respond to the dying person's desire or need for spiritual expression, connection and support. Moreover, simple caregiving responses can have profoundly positive impacts on quality of life for clients/patients and their loved ones. This workshop will review spiritual needs commonly encountered at the end of life, toward strengthening the provider's spiritual assessment skills.
— Rabbi Natan Fenner, BCC, Bay Area Jewish Healing Center, Institute on Aging
AFTERNOON WORKSHOPS — 2:45 TO 4:15 PM
1B. End-of-Life Care for Persons with Dementia
Dr. Olson will guide the participants in evaluating and treating the symptoms of persons presenting with dementia. Managing the more difficult issues faced in the care of patients with dementing illness, and the medical and psycho-social challenges of caring for this population through the end of life will provide the main focus for this workshop. The decision-making processes related to medical care and placement and palliative care will be included.
—Ellen Olson, MD, Medical Director, Geropsychiatric Community Living Center, Menlo Park Division, Palo Alto VA Health Care System and Clinical Associate Professor, Department of Medicine, Stanford School of Medicine
2B. "Go Wish": A Tool for Easing Difficult Conversations in Advance Care Planning
Workshop participants will learn about the development of the "Go Wish" card game and will try out the game themselves. The presenters will give case examples to illustrate how the game can be useful in end-of-life decisions, interpreting advance directives, communicating with adults with diminished capacity, family conflict resolution, medical decision-making, and working with health care professionals on behalf of your clients.
— Elizabeth S. Menkin, MD, Clinical Medical Director, San Diego Hospice at The Institute for Palliative Medicine
— Gail Cobe, RN, MSN, Clinical Nurse Specialist for Dementia Programs, Laguna Honda Hospital
3B. Suicidal Ideation at the End of Life
Dying and death in our society has been shrouded in anxiety, fear, horror, denial and mystery for many of us. Physical illness, dwindling resources, and limited coping skills increase troubling thoughts of suicide in older people who have the highest rate of suicide of any age population. To ease some of the discontent of our older adults who may be contemplating suicide as a way of controlling painful feelings, we can help them learn how to forgive themselves and/or others.
— Patrick Arbore, EdD, Director, Center for Elderly Suicide Prevention & Grief-Related Services, Institute on Aging
4B. Doorway Thoughts: Religious and Spiritual Diversity
This session will provide insight into the faith perspectives of some of our immigrant elders and how their culture and religion sustain them in difficult times. We will provide a safe space for exploring ethical and religious dilemmas. The goal will be to address how to integrate these cultural and spiritual values into care at the end of life.
— Marita Grudzen, MHS, Deputy Director, Stanford Geriatric Education Center
— Taqwa Surapati and Sherifa Ibrahim, Muslim Spiritual Care Coordinators, Stanford University Medical Center
— Rev. Edmond Yee, MDiv, PhD, Professor Emerita of Asian Studies, Pacific Lutheran Theological Seminary
NEW!
IOA's 2010 Educational Series
Mind, Body, Spirit: Pathways to Improving Health