Nancy Joyner – Nearing the End of Life

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Summary

• Archive: Nancy Joyner - Nearing the End of Life An Inexact Art & Science Illness and dying trajectories Frailty Dementia Prognostication and prognostic scales When to refer to palliative care or hospice (disease specific) Essentials of Care: Comfort, Communication, Choices, Control Comfort Always Morphine: Still the gold standard?

• Pain during the final hours of life Drug misuse: How to avoid it Opioids for dyspnea Thirst vs.

• xerostomia Medical marijuana Complementary and alternative therapies Emotional distress interventions The role of spirituality Palliative sedation Communication: Everyone is Involved Advance care planning: More than just a form The terminology matters Your role in these critical conversations How much can we share?

• hope Code status discussions DNR does not mean do not treat Addressing concerns and needs of the family Thanatophobia: Is it fear of dying or fear of death?

• Premortem surge Near death awareness The dying process Choices: Shared Decision-Making Nutrition & hydration choices Voluntarily Stopping Eating and Drinking (VSED): Benefits & burdens Life-sustaining treatment Non-beneficial treatment choices Faith-based influences Ventilator support Dialysis or renal palliative care Devices to extend life Hastened death request: Why not humanely euthanize?

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