Mindful Continuing Education

Facilitating End of Life Care

1. Generally speaking, people who are dying need care in four significant areas, including physical comfort, mental and emotional needs, spiritual issues, and practical tasks.

A. True B. False

Physical Comfort

2. In addition to providing pain relief, morphine may be use as part of end of life care to:

A. Reduce anxiety B. Help with sleep disturbances C. Ease the feeling of shortness of breath D. Lessen sensitivity to environmental factors

Mental and Emotional Needs

3. A dying person may experience depression, anxiety, fear, and various other emotions, and physical touch such as holding hands or a gentle massage can be very comforting.

A. True B. False

Spiritual Issues

4. While experts recommend talking to dying patients even when unconscious, they don't recommend discussing specific memories as this may be very distressing to individuals as they realize they will not likely be around to share future experiences.

A. True B. False

Palliative Care and Hospice

5. Each of the following is an accurate statement about palliative care EXCEPT:

A. Palliative care now often refers to a comprehensive approach to improving the quality of life for people who are living with potential fatal diseases B. In a palliative care program, a multidisciplinary health care team works with both the patient and family to provide any support C. Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics, certain other specialized clinics, or at home D. In palliative care, patients are asked to make a choice between treatment that might cure an illness or prolong life and comfort care so that the team can develop an appropriate plan

Some Differences Between Palliative Care and Hospice

6. Some of the similarities between palliative care and hospice are that both services will treat anyone with a serious illness and both are covered by Medicare.

A. True B. False

7. In the United States, older people can receive hospice care through Medicare if their health care provider thinks they have less than 6 months to live, and even after six months if the doctor continues to certify that that person is close to dying.

A. True B. False

Dementia

8. Alzheimer's disease and similar conditions often progress slowly and unpredictably, but signs of the final stage of Alzheimer's disease include being unable to move around on one's own, being unable to speak or make oneself understood, needing help with most, if not all daily activities, and:

A. Eating problems such as difficulty swallowing or no appetite B. Rapid increase in anxiety and irritability C. Excessive fatigue and sleep difficulties D. Increase in uninhabited behavior

Health Care Decisions

9. When ask to make advanced health care decisions for someone who is no longer able to do so, it may be helpful to put yourself in the place of the person who is dying and try to choose as he or she would, which is known as:

A. Best interest determination B. Substituted judgment C. Alternative evaluation D. Reciprocal agreement

10. Some experts believe that at the end of life, a feeding tube might cause more discomfort than not eating, and as death approaches, loss of appetite is common and body systems start shutting down, and fluids and food are not needed as before.

A. True B. False

When Someone Dies

11. The term dyspnea refers to the shutting down of bodily organs, which occurs at the very near end of life.

A. True B. False

Getting Help

12. An essential part of hospice is providing grief counseling to the family of someone who was under their care, and even if hospice was not used at the end of life, loved ones can ask hospice workers for bereavement support following the death.

A. True B. False

Advance Directives and Other Documents

13. Which of the following is NOT an accurate statement about advance directives related to serious illness and end of life care?

A. A living will records end-of-life wishes in case the individual is no longer able to speak for him/herself B. Through a durable power of attorney for health care, a person can be chosen to make care decisions for an individual who is no longer able to do so C. The terms durable power of attorney for health care and durable power of attorney are used interchangeably to describe end of life care decisions D. If a proxy or representative is not named, an order of priority for care decisions will likely be based on the nature of the family relationship

14. Sometimes people change their mind as they get older or after they become ill, so they should review the decisions in their advance directives from time to time and make changes if desired.

A. True B. False


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