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Family Adjustments at End of Life

presented by Lu Krieger-Blake LCSW, MSW, BA

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Disclosure Statement:

Financial— Lu Krieger-Blake receives compensation from MedBridge for the production of this course. There are no other relevant financial relationships. Nonfinancial— No relevant nonfinancial relationship exists.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 82 Minutes; Learning Assessment Time: 31 Minutes

When a patient is facing end of life (EOL), the family and caregivers are also profoundly affected by the changes experienced by the patient. This course will provide information for nurses, therapists, and social workers in a variety of settings so that they may be aware of issues facing the patient and family, promoting sensitivity to the family's needs as they care for the patient. Advance care planning, role changes, anticipatory, and post-loss grief issues will be discussed.

Meet Your Instructor

Lu Krieger-Blake LCSW, MSW, BA

Luana S. "Lu" Krieger-Blake LCSW, MSW, BA Lu Krieger-Blake has been a clinical practitioner for all 45 years of her Social Work career. In her 25 years as a hospice medical social worker, she lived out her "heart's mission" by bringing her compassion and skill to help patients and families navigate their end-of-life process. A…

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1. Advance Care Planning and Hospice Care

Nurses are often the frontline personnel in working with patients with life-ending illness, and their families and/or caregivers. Social workers and therapists are also frequently involved with patients nearing the end of life as circumstances change for the patient and family. These disciplines need to be aware of options for the on-going care that is required when curative treatment is no longer effective, appropriate, or desired. Awareness of the hospice philosophy and advance care planning options are important in order to ease some of the patient's necessary transitions. This chapter will discuss legal options available for patients to designate the type and extent of care they wish to receive. These options often lead to hospice care which supports the patient as well as their family/caregivers.

2. Role Changes and Adjustments

Patients, families, and caregivers are often surprised by the changing roles they encounter as the patient’s disease progresses. Professional staff are often faced with recognition of these different “vibes,” and can be helpful in acknowledging these role changes and the accompanying emotions experienced by all parties.

3. Psycho-Social, Emotional, and Spiritual Issues at End of Life

As patients and their families progress through the disease process, they face many unknowns that may create adjustment issues for them in a variety of circumstances. This chapter will identify some of these issues, and propose possible adaptations to enhance patient and family coping and comfort.

4. Loss and Grief

Anticipatory grief begins with the patient’s diagnosis, as the possibility of a "future" is profoundly altered. The family “lives” with how the patient dies. The family continues to relive the memories of the death process long after the patient is gone. Grief can be complicated if the dying process was not perceived as peaceful and comfortable. Education for the family prior to the death is key for nurses as they accompany their patient and CGs on this journey. This chapter will discuss how, throughout the course of the illness, there are many changes in physical condition, which precipitate changes in emotional and spiritual adjustments to grief.

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