The Dying Process

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Each person’s death is unique and each person has his/her own understanding, views and attitudes toward death. Participate in this module to learn about death and dying within a social, cultural and personal context. Participants will identify the signs of impending death, non-pharmacologic and pharmacologic approaches to managing symptoms during the dying process, become familiar with “The Conversation” for assisting with end of life decisions and appreciate the value of the clinicians’ “Pause” at the time of death.

Author Information

Christopher G. Mitchell, PhD, LCSW
Associate Dean for Doctoral Studies and Academic Programs
Jane Addams College of Social Work
Co-Investigator, ENGAGE-IL
University of Illinois at Chicago

Valerie Gruss PhD, APN, CNP-BC
Associate Professor
College of Nursing
Director, ENGAGE-IL
University of Illinois at Chicago

Author Bios:
Dr. Christopher Mitchell, MSW, PhD, LCSW, is Associate Professor and Director of Academic Program Development and Assessment at the Jane Addams College of Social Work, University of Illinois at Chicago, and is a member of the Commission on Educational Policy at the Council on Social Work Education (CSWE). He is an experienced clinical social worker with expertise in cognitive behavioral and motivational treatment approaches for persons with mental health and substance use problems. His research addresses the psychosocial and behavioral aspects of HIV with particular focus on HIV prevention and medication adherence. Dr. Mitchell teaches graduate courses in psychopathology, clinical social work practice, and integrated care.

Valerie Gruss, PhD, APN, CNP-BC, is Associate Professor in the UIC College of Nursing. She is a board-certified Nurse Practitioner with a broad range of clinical expertise and research experience working in primary care and with multidisciplinary teams in a variety of settings. Dr. Gruss’ position at UIC blends her roles as researcher, clinician and educator.
In 2015, Dr. Gruss was awarded a $2.5 million three year grant through the HRSA Geriatrics Workforce Enhancement Program (GWEP), to create an interprofessional education program for improving the care of older adults. Dr. Gruss clinical role is as Lead Clinical Consultant on a Federal Demonstration Project for the State of Illinois, “Money Follows the Person”, which transitions eligible seniors out of nursing homes and back to the community. As an educator, Dr. Gruss teaches primary care and geriatrics in the UIC College of Nursing graduate program. In pursuit of changing current nursing education to a more interdisciplinary model, she is very involved in interprofessional education and serves on the Vice Chancellor’s IPE Steering Committee.

Kathy Plakovic, APN, ACHPN, AOCNP
Nurse Practitioner
Edward Hospital

Ruth Palan-Lopez, PhD, GNP-BC
Program Director
Doctor of Nursing Practice
MGH Institute of Health Professions

Contributors bio:
Kathy Plakovic is a family nurse practitioner at Edward Hospital in Naperville, IL. She completed a fellowship in pain and palliative care at Memorial Sloan Kettering Cancer Center in New York. Kathy is board certified as a family nurse practitioner and holds advanced certification in hospice and palliative care as well as oncology. She assisted in the development of the palliative care programs at the University of Illinois Medical Center in Chicago and Edward Hospital. Kathy received the Sigma Theta Tau Award for Clinical Excellence in 2013 and the Healthy Driven Hero award in 2016. She has authored book chapters and journal articles on palliative care topics. She is a strong patient advocate and assists patients and families to ensure their preferences for care are respected. She also provides symptom management and psychosocial support to patients and families as a member of the interdisciplinary palliative care team at Edward Hospital.

Ruth Palan Lopez is Professor of Nursing and Director of the Doctor of Nursing Practice Program at the MGH Institute of Health Professions. Ruth received a BS in nursing from Boston College, MS in nursing from Boston University, PhD from Boston College, and was a Claire M. Fagin Post-doctoral Fellow (2007-2009). Her career focuses on empowering nurses through education, leadership, and research. Her clinical work as a gerontological nurse practitioner included providing care to older adults in multiple settings, including primary, acute, and long-term care. She fostered the growth of NP practice in Massachusetts, including prescription writing authority through her leadership positions on the Massachusetts Coalition of Nurse Practitioners. Dr. Lopez’s research focuses on people with dementia and their family caregivers. She is pioneering a nurse-led movement to ensure that Intensive Individualized Comfort Care is made accessible as an alternative to Aggressive Care at end of life. Her positive influence of care of older adults was recognized by her induction as a fellow in the Gerontological Society of America and the American Academy of Nursing.

Memoona Hasnain MD, MHPE, PhD
Professor and Associate Department Head, Faculty Development & Research
College of Medicine,
Department of Family Medicine
Co-Director, ENGAGE-IL
University of Illinois at Chicago

Expert Interviewee (bio above as author):
Christopher G. Mitchell, PhD, LCSW
Associate Dean for Doctoral Studies and Academic Programs
Jane Addams College of Social Work
Co-Investigator, ENGAGE-IL
University of Illinois at Chicago

Module Information

Duration: 30 minutes
Format: Video Stream & pdfs

Module Guide and Handout
Resources & References
Continuing Education Credit Information

In support of patient care, Rush University Medical Center is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education for the healthcare team.

Rush University Medical Center designates this live activity for a maximum of (0.50) AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

This activity is being presented without bias and without commercial support.

ANCC Credit Designation – Nurses
The maximum number of hours awarded for this CE activity is 0.50 contact hours.

Rush University is an approved provider for physical therapy (216.000272), occupational therapy, respiratory therapy, social work (159.001203), nutrition, speech-audiology, and psychology by the Illinois Department of Professional Regulation. Rush University designates this live activity for (0.50) Continuing Education credit(s).

Rush University Medical Center designates this knowledge based CPE activity for 0.50 contact hours for pharmacists.

Learning Objectives

Upon completion of this module, learners will be able to:

Discuss death and dying in a social, cultural, and personal context
Describe the four domains of comfort care at the end of life
Identify non-pharmacologic and pharmacologic approaches to managing symptoms and issues of dying
List the signs of impending death
Recognize “The Conversation” instructions for end of life decisions
Summarize the value of the clinician’s “Pause,” including how it can be applied to their practice

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