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NACC PSW Program, Module 14Assisting the Person Who is Dying

and Their Family: Essentials in Hospice Palliative Care

Kath Murray BSN, MA, CHPCN(C), FT

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Do you have copies of:

• Module 14 – NACC PSW Curriculum?

• Essentials in Hospice Palliative Care

• Text

• Study Guide

• DVDs x 5

• DVDs

• PPTs

• Instructors Guide, downloaded and printed?

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My goals

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Your goals

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Life and Death Matters contact info

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Web resources

• www.lifeanddeathmatters.ca

• Blog - www.lifeanddeathmatters.ca

• http://www.facebook.com/LifeAndDeathMatters

• Twitter - @LDMatters

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PowerPoint posted online:

Shareslide – see online

http://www.slideshare.net/lifeanddeathmatters

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Terminology

Personal Support Worker =

Health Care Worker

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Why Integrate Hospice Palliative Care in Education??

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“Shh”

Life is terminal!

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Most of us will die with chronic illness

• Trajectory is unpredictable

• Half of us will not know a week in advance that we will be dead the following week

• If we wait until time of death is known, we will miss the benefits of HPC

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HPC is not just a program or a place

• Clear evidence for the benefit of integrating a palliative approach for people dying with chronic illnesses, earlier in the disease process, across all settings,

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A palliative approach recognizes that

although not all people with life-limiting illness require specialized palliative services, they do require care that is aimed at improving quality of life by preventing and relieving suffering through early identification, assessment, and treatment of physical, psychosocial, and spiritual concerns

(Krisjanson, Toye, & Dawson, 2003).

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All settings…

Desire for great care and a safe place to

die, whether in a facility, acute care,

emergency, facility, or at home!

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FYI: LTC Stats….

• Over 70% of direct care is provided by PSWs!

• Nearly 100% of residents die in LTC

• LOS is becoming shorter

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Module 14

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Module 14 – Assisting the person who is dying and their family: Essentials in HPC

• Time – 22 hours

• Learning outcomes

• Content guidelines

• Resources (Instructors Guide, Text, Study Guide, Podcasts, PPT, DVD)

• Evaluation• Study Guide• Group Assignment• Final Test

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Content - sessions

• HPC principles, philosophy

• “On being up close & personal with the dying”

• Physical comfort - common issues

• Care in the last days & hours and following death

• Self care

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Module 14 is supported by “Essentials in HPC Resources”

• Competency based

• Developed to address diverse learning needs

• Can be adapted to meet the needs of your students

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Let’s start with the Instructor’s Guide

• Download http://lifeanddeathmatters.ca/facilitators-forums/instructors-guide.html

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Instructors Guide - Outline

• Intro

•Page 13-16

•Comments? Questions?

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Guide

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Timing

• When to teach Module 14?

• Module 11,12,14,13

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When to give students the resources?

• First week

• Module 6 or 7

• Assign the Reflective Writing

• Invite students to browse through the text

• Assign readings as they become pertinent to what students are talking about or dealing with

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How to dovetail

• Respiratory system

• Talk about difficulty breathing

• Show the DVD on dyspnea

• Communications

• PPT on loss and grief

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Let’s practice with the section on dyspnea

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Dyspnea

• Teaching Time: 1.5 hours

• (with Comfort Basket add .5 hours)

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Learning Outcomes

At the end of this unit learners will be able to:

• Experience dyspnea…

• Identify 5 questions to ask and observe...

• Identify three comfort measures...

• Provide a sample report on a patient….including a request for nurse to help.

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Resources at a glance

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Supplies, Preparing

• Bring in three straws…

• Instructor Preparation

•Reading

•Comfort basket

•Preview DVD “Dyspnea” and PPT

•Familiarize self with the material

•Choose activities, discussion points,

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Videos

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Video Activity

Straw exercise –

See also page 61 text

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Essentials Text

• Definitions/intro – 60-61

• Assessing - 62

• Managing - 63-65

• Comfort Strategies-65-68

• Predeath respiratory congestion

- 69-72

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PowerPoints – Dyspnea

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Time savers…

Lecture notes for instructors include:

Links to resources

Key points

Supplemental information for use at instructor’s discretion.

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“Customize”

Instructors can

• Personalize for particular needs

• Localize for each community

• Adapt to stimulate discussion

• Customize for instructors

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Study Guide

• 29 q 2

• 29 q 3-5

• 30 q 6

• 31 q 11

• 31-33

• 34-36

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Beliefs and Baggage

•Following the exercise on breathing with a straw, … write about your experience with difficult breathing. What did this feel like to you?

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Concepts and Content

•List physical behaviours that you might observe with dyspnea:

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Gather information about:

• Respiratory rate

• Breath sounds

• Periods of shortness of breath

• Pauses for breath when talking?

• Shortness of breath on exertion?

• Does it settle with rest?

• Cough/congestion

• Skin color

• Fever

• Anxiety or fear

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Integration and Application

Use the FH SAA, ask Jason questions about his dyspnea…..

Study Guide – p.30

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Ways to comfort during acute episodes

• Acknowledge patient’s

“I can hear that you are

uncomfortable…”

• Touch may help ground individual

• Provide a focus message

“Look in my eyes…”

“Breathe with me…”

• Oxygen

Use with discretion

pg. 67

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Integration and Application

• Lab

• Clinical setting

• Case studies

• Questions

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Podcasts

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Comfort Basket

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Marking

Final Mark

•Study Guide 35%

•Group Assignment 20%

•Final Test 45%

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Group Assignment

• Information for the instructor

• Information for the students

• Marking scheme (give students a copy)

• Case Study #1

•Patient role

•PSW role

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Ordering form

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THE ARBUTUS TREE

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The Arbutus Tree

A symbol of…

• Strength

• surviving and thriving in harsh conditions

• Growth at the edge between land and sea, between life and death

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Teaching is in invitation to learn

And learning is an invitation

to teach….

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Thank you!

•Feedback and evaluation

•kath@lifeanddeathmatters.ca

• info@lifeanddeathmatters.ca