ELNEC Geriatric Module 9: Final Days


The final days and hours of an older adult's life create unique physical, psychosocial, and spiritual issues that the palliative care team must address. In this course, you will learn your role as a nurse in caring for older adults and their families during their final days or hours. You will also learn about the nursing care required during the final hours and that required after death.


Hours: 1.25


Certificates provided by accrediting body (0 Match)

Course Details

Hours: 1.25
Type: Online Course
Content Expiration Date: 2/28/2019
Learning Objectives:
Explain the roles of the nurse at the end of life including advocacy, maintaining a therapeutic presence, and support during the death vigil.

Describe the care needs of older adults during the final hours of life.

Identify the elements of after-death care for the deceased and their family.

Section 1: Introduction A. About This Course B. Learning Objectives Section 2: The Role of the Nurse A. Care at the End of Life B. Person-Centered Care C. Your Role D. Advocacy E. Meet Billy F. Establish Daily Priorities G. Create a Comfortable Environment H. Maintain Presence and Caring I. Communication J. Testimonial #1 K. Offer Support L. Review M. Summary Section 3: Care in the Final Days A. Nearing-Death Phenomena B. Two Roads to Death C. Testimonial #2 D. Hierarchy of Needs E. Frequency of Symptoms F. Pain G. Pain Management H. Terminal Secretions I. Managing Terminal Secretions J. Pharmacologic Management K. Terminal Delirium L. Treating Terminal Delirium M. Psychosocial and Spiritual Symptoms N. Imminent Death O. Letting Go and Saying Good-Bye P. Review Q. Summary Section 4: Care After Death A. Signs of Death B. Death Pronouncement C. Postmortem Changes D. After-Death Care E. Assisting the Family F. Review G. Summary Section 5: Conclusion A. Summary B. Course Contributor C. Resources D. References E. Congratulations

Instructor: Judith Paice, PhD, RN, FAAN
Judith Paice, RN, PhD, FAAN is currently the Director of the Cancer Pain Program in the Division of Hematology-Oncology and a Research Professor of Medicine, Northwestern University, Feinberg School of Medicine. She is also a full member of the Robert H. Lurie Comprehensive Cancer Center. Dr. Paice is a past President of the American Pain Society, served as Secretary of the International Association for the Study of Pain. Much of Dr. Paice’s clinical work has been in the relief of pain associated with cancer and HIV disease. Her research interests include: chemotherapy-induced peripheral neuropathy; quality improvement measures to foster pain relief; and adverse effects associated with analgesics. In 2002, the American Pain Society honored Dr. Paice with the Narcessian Award for Excellence in Teaching. She has traveled extensively internationally to educate healthcare professionals regarding cancer pain relief. Dr. Paice serves on the editorial board of Clinical Journal of Pain, Journal of Pain, and Journal of Pain and Symptom Management and has published numerous articles, alone and collaboratively, in the areas of pain management and research. Dr. Paice is also a co-editor for the 2015 Oxford Textbook of Palliative Nursing. She earned an MS in oncology nursing from Rush University in Chicago and a PhD from the University of Illinois at Chicago, studying pain modulation pathways in an animal model. Disclosure: Judith Paice, PhD, RN, FAAN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Instructor: Susan Gibson RN FNP-BC, ACHPN
Susan Gibson, RN, FNP-BC, ACHPN is a nurse practitioner working in both palliative and hospice care. Ms. Gibson is the program coordinator for the Community Palliative Care program in Santa Barbara which was awarded the CHAPCA 2011 Outstanding Program Achievement Award. She sees her patients across all care settings including their home, ambulatory and acute care, and in skilled nursing facilities. Ms. Gibson also cares for patients as the Attending clinician in an 18-bed inpatient/residential hospice facility and is responsible for the education in pain and symptom management of both the facility and home hospice clinical nursing staff. She has been instrumental in educating nurses in her community about end of life nursing care through annual ELNEC courses. She is also a published author in the field of palliative and hospice care. Ms. Gibson began working with dying patients as a hospice volunteer with end of life work serving as the impetus to enter the nursing field. Her initial nursing education was funded through a scholarship from a hospice agency. Throughout her career as a registered nurse, she has always been drawn to the care of dying patients and their families regardless of the setting, from surgical/trauma intensive care to an inpatient hospice facility to working as a palliative care nurse in an acute care facility. She is a Respecting Choices certified Advance Care Planner facilitator. She is also a graduate of the Sacred Art of Living Anamcara Project, a project designed to prepare healthcare providers to be fully present at the bedside and is actively involved in Viagenco, a sister hospice in Kenya.  Disclosure: Susan Gibson RN FNP-BC, ACHPN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Instructor: The National ELNEC Project
 Disclosure: The National ELNEC Project has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: entry, intermediate, and advanced level Nurses; intermediate level Social Workers; in the following settings: Hospice, Palliative Care.
F Tags:
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Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
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