Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2: The Role of the Nurse

Care at the End of Life

Person-Centered Care

Your Role

Advocacy

Meet Billy

Establish Daily Priorities

Create a Comfortable Environment

Maintain Presence and Caring

Communication

Testimonial #1

Offer Support

Review

Summary

Section 3: Care in the Final Days

Nearing-Death Phenomena

Two Roads to Death

Testimonial #2

Hierarchy of Needs

Frequency of Symptoms

Pain

Pain Management

Terminal Secretions

Managing Terminal Secretions

Pharmacologic Management

Terminal Delirium

Treating Terminal Delirium

Psychosocial and Spiritual Symptoms

Imminent Death

Letting Go and Saying Good-Bye

Review

Summary

Section 4: Care After Death

Signs of Death

Death Pronouncement

Postmortem Changes

After-Death Care

Assisting the Family

Summary

Section 5: Conclusion

Summary

Course Contributors

Resources

References

The ELNEC Project, which began in 2000, is a partnership between the American Association of Colleges of Nursing (AACN), Washington, DC and the City of Hope, Duarte, CA. For more information about ELNEC, go to www.aacnnursing.org/ELNEC

The content for this course was created or revised by:

Carol O. Long, PhD, RN, FPCN, FAAN is a national and international expert in geriatric palliative care and community-based health delivery and is the founder of Palliative Care Essentials. Dr. Long has been a registered nurse for over 40 years holding various staff, management, education, and consultant positions. She has numerous articles, book chapters, abstracts, and monographs related to end-of-life care, hospice, pain management, and palliative care for advanced dementia and has presented and provided program consultation in the US and throughout the Middle East, Southeast Asia, Australia, and Latin America. Her research centers on outcome indicators in advanced dementia care and staff knowledge and attitudes relative to palliative care interventions. Dr. Long has been an ELNEC (End-of-Life Nursing Education Consortium) trainer since the course's inception. Dr. Long is a Fellow in Palliative Care Nursing with the Hospice and Palliative Nurses Association; a Transcultural Nursing Scholar with the Transcultural Nursing Society; and a Fellow in the American Academy of Nursing. She holds a BSN from Marquette University, MS from the University of Michigan, and PhD from Arizona State University where she is adjunct faculty.

This course was reviewed by:

Pam Malloy, MN, RN, FPCN, FAAN is an oncology clinical nurse specialist with over 40 years of experience in clinical oncology and palliative care nursing, staff development, education, program development, and administration. Ms. Malloy is currently the national Director and Co-Investigator of the End-of-Life Nursing Education Consortium (ELNEC) Project and Special Advisor on Global Initiatives at the American Association of Colleges of Nursing (AACN) in Washington, DC. She serves as faculty for all the national ELNEC courses and has presented ELNEC in 12 international countries. In addition, she has developed palliative care nursing leadership curricula, taught, and mentored current and future nursing and physician leaders throughout Eastern Europe, Kenya, and Asia. Ms. Malloy directed the California Endowment project for AACN on developing cultural competencies for undergraduate and graduate nursing students. In addition, she collaborated with the US Department of Veterans Affairs to develop the ELNEC-For Veterans curriculum, which was presented to over 500 nurses, representing every VA hospital across the nation. Ms. Malloy serves on the Board of Directors of Living Room International—which provides hospice/palliative care services in Kipkaren, Kenya. She has also served on the Board of Directors for the Leukemia, Lymphoma Society/Washington, DC Chapter and the Hospice and Palliative Nurses Foundation (HPNF). Ms. Malloy is a Florence Wald Fellow, a Fellow in Palliative Care Nursing (FPCN), and the American Academy of Nursing (FAAN). She has written and had published numerous articles in peer-reviewed journals, has written chapters for various textbooks, and currently consults on three palliative care grants. She was recently presented with a Lifetime Achievement Award from the MD Anderson Cancer Center.

Disclosure: The National ELNEC Project - GER 2018 has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.