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Modules:

  • Introduction
  • 1. Advance Care Planning
  • 2. Communicating Bad News
  • 3. Whole Patient Assessment
  • 4. Pain Management
  • 5. Assisted Suicide Debate
  • 6. Anxiety, Delirium
  • 7. Goals of Care
  • 8. Sudden Illness
  • 9. Medical Futility
  • 10. Common Symptoms
  • 11. Withholding Treatment
  • 12. Last Hours of Living
  • 13. Cultural Issues
  • 14. Religion, Spirituality
  • 15. Legal Issues
  • 16. Social and Psychological
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    Back to Module 3: Whole-Patient Assessment
    Nine Dimensions

    Step 1. Illness/Treatment Summary
    Step 2. Physical
    Step 3. Psychological
    Step 4. Decision-Making
    Step 5. Communication & Information Sharing
    Step 6. Social
    Step 7. Spiritual
    Step 8. Practical
    Step 9. Anticipatory Planning for Death

    Step 1. Illness/Treatment Summary

    The patient seeking end-of-life care will likely have a long history with multiple interventions. A complete history should include:

    • Primary diagnosis
      • Illness's effects
      • Treatment's adverse effects
    • Secondary concurrent illnesses
    • Treatment summary

    Before moving beyond assessment to making a care plan for the patient:

    • Consider whether previous treatments were appropriate based on:
      • Their known effectiveness
      • Patient preferences
    • Verify that appropriate curative treatments have been considered
      • If not, present these options to patient and proxy
    • Consider that efforts to control the underlying disease may be appropriate even in advanced stages of illness
      • Especially true with pediatric patients, whose parents may desire curative or life-prolonging therapy even in the face of poor prognosis
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