Evolving the conversation with your patients from “I’m sorry you are going to die” to “Let me help you experience a good and peaceful death”. This video will demonstrate how to clearly communicate the nine evidence-based elements to a good and peaceful death and how to structure that conversation with your patient.
What you will learn from this module:
- No matter what someone’s eventual cause of death will be, including our own, people will benefit from learning the 9 elements and how to achieve them.
- The timing of when to have such a discussion with a patient with advanced cancer very much influences her willingness to listen to her oncology specialist/provider of care, and be ready to embark on fulfilling these 9 elements.
- There is benefit in being able to tell a patient that you, her doctor, has already completed these 9 elements for yourself, demonstrating that they are appropriate for everyone, no matter their current health status. By doing so, it doesn’t cause the patient to feel that they have to complete it because they are dying.
- Patients all have different personal psychosocial experiences over their lifetime and these experiences and relationship with family and others influences how they approach each of these elements and complete them.
- Fulfilling these 9 elements cannot be achieved in a few days. This is why it is important to have this discussion in advance of a patient literally approaching end of life. Patients may need as much as 2 months to complete all of these elements, each one taking a different length of time.
- Helping patients learn about the 9 elements and making it an assignment for them to complete is a way to give patients something they can control during a time that they feel they cannot control anything.
- Some answers to these 9 elements will be surprising to you, and will provide you greater insight into your patients’ psychosocial history and current needs.
- You as the patient’s provider of care should launch the discussion about the 9 elements however there is no expectation that you need to help the patient literally think about each one with you and provide the answers. It is also okay to delegate someone like a nurse navigator, psyche nurse from your oncology team, social worker, or therapist to review in detail with the patient each element.
- Each element carries its own weight in the eyes of the patient. Some elements may be considered by her to be the most important ones to her where another patient identifies totally different ones that she sees as major. Making sure however that legal and financial affairs are in order is critical for everyone, including ourselves, and should be prioritized as such.
Speakers
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
University Distinguished Service Professor of Breast Cancer Professor of Surgery
Johns Hopkins University School of Medicine
Co-Developer, Work Stride- Managing Cancer at Work
Johns Hopkins Healthcare Solutions
Co-Founder, Academy of Oncology Nurse & Patient Navigators (AONN+)
Co-Founder, Association of Chronic & Complex Care Nurse Navigators (ACCCNN)
Baltimore, MD, USA
Her name is well known in the cancer field, especially in navigation, survivorship, patient centered care, preservation of quality of life, end of life planning and care, improving the cancer patient’s experience, breast cancer and clinical outcomes. She clinically specializes in breast cancer care. Her public speaking, literary work, and notable roles she has held over the last 40+ years are well known to many.
Accreditation and Disclosure Information
Target Audience
This activity is intended for physicians, nurses, and physician associates.
Educational Objective
After completing this CME activity, the participant should be better able to:
- Formulate "the nine elements" that need to be accomplished by the patient with advanced cancer.
Providers
This activity is brought to you by Medical Learning Institute and Mission Critical Health.
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In support of improving patient care, Medical Learning Institute, Inc. is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
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Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nursing Continuing Professional Development
Successful completion of this nursing continuing professional development activity will be awarded 0.5 contact hour.
PA
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This educational activity may contain discussions of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this CE activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the CE activity are those of the presenters and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
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Faculty Disclosures
Planner/Presenter
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
The Johns Hopkins University School of Medicine
Baltimore, MD, USA
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG, has a financial interest/relationship or affiliation in the form of:
Speakers’ Bureau: Pfizer Oncology
All of the relevant financial relationships of individuals for this activity have been mitigated.
Planning Committee and Content/Peer Reviewers
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Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this CE activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this CE activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.
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Resources
- Cost of Cancer Care: Issues and Implications
- Financial Navigation Can Reduce the Financial Toxicity of Cancer Care
- What is an “early palliative care” intervention? A scoping review of controlled studies in oncology
- Exploring the spiritual needs of patients with advanced cancer in China: a qualitative study