Seminar Detail

Nearing the End of Life: Dare to Care
Nearing the End of Life: Dare to Care

Where:  BOWIE, MD

When:  Thursday, March 8, 2018 at 8:00 AM - 4:00 PM

Other ways to Register: Call (800) 844-8260   |   Printable Form (fax or mail)
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Single Registration
2+ Group Rate: per person
*** All prices are shown in US Dollars ***
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BOWIE, MD 20716
Phone:  301-464-0089
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Course Description:

Eleanor is an 83-year-old widowed lady with known chronic heart failure and advanced dementia. She is now hospitalized with a significant stroke and dysphagia. She does not have a healthcare directive and had never discussed what she would want, other than staying at home until she dies. She is full code. Her family still wants resuscitation attempted. Her children admit they are concerned about what is best for their mother.

What are options for Eleanor and her family? Would she benefit from artificial hydration and nutrition? How is she going to receive medications? Can some of her medications be discontinued? Who is going to be her caregiver?

In this compelling seminar, multiple case studies like Eleanor's will provide you with examples that you can incorporate when care is more important than cure. To deliver expert, holistic care, healthcare professionals need to have a toolbox full of new interventions to promote quality care at the end of life.

Have you ever been asked, "what would you do if this was your family member?" Learn conversation options to use while staying neutral.

Did you know that a patient might enroll on hospice care and be a full code? We will discuss how this is done.

What can we do for patients seeking euthanasia who see this as the best solution? These situations are becoming more frequent. Anticipate how you will respond.

Strategies regarding comfort, communication, choices and control have unique issues and challenges for patients, families and health professionals. We have an obligation to know how to help provide emotional, spiritual, existential, and physical comfort for those who have life-limiting conditions and to support them through difficult decisions. It’s time to think outside the box.
If there is no CE tab, please refer to the course brochure for continuing education information.
Learner Objectives:

  1. Explain how complementary therapies enhance quality of life for patients.
  2. Evaluate the risks and benefits of medical marijuana.
  3. Acknowledge the eight domains of the National Consensus Project.
  4. Recognize two strategies to overcome fear of death.
  5. Analyze five complications related to artificial hydration and nutrition.
  6. Explore ethical issues often seen at the end of life.
  7. Formulate two strategies to diminish fear of death and dying.
  8. Connect moral resiliency to palliative care.
Program Outline

  • An Inexact Art & Science
    • Illness and dying trajectories
    • Frailty
    • Dementia
    • Prognostication and prognostic scales
    • When to refer to palliative care or hospice (disease specific)
  • Essentials of Care: Comfort, Communication, Choices, Control

  • Comfort Always
    • Morphine: Still the gold standard?
    • Pain during the final hours of life
    • Drug misuse: How to avoid it
    • Opioids for dyspnea
    • Thirst vs. xerostomia
    • Medical marijuana
    • Complementary and alternative therapies
    • Emotional distress interventions
    • The role of spirituality
    • Palliative sedation
  • Communication: Everyone is Involved
    • Advance care planning: More than just a form
    • The terminology matters
    • Your role in these critical conversations
    • How much can we share?
    • Truth vs. hope
    • Code status discussions
    • DNR does not mean do not treat
    • Addressing concerns and needs of the family
    • Thanatophobia: Is it fear of dying or fear of death?
    • Premortem surge
    • Near death awareness
    • The dying process
  • Choices: Shared Decision-Making
    • Nutrition & hydration choices
    • Voluntarily Stopping Eating and Drinking (VSED): Benefits & burdens
    • Life-sustaining treatment
    • Non-beneficial treatment choices
    • Faith-based influences
    • Ventilator support
    • Dialysis or renal palliative care
    • Devices to extend life
    • Hastened death request: Why not humanely euthanize?
  • Allowing Control: Patient-Centered Care
    • Reframing hope
    • What do family members want you to consider
    • Who makes the decision
    • What about family dysfunction…
    • Is the focus quality or quantity?
    • Decision to withhold or withdraw care
    • Challenging decisions: Honoring patients' wishes
  • Cultivating Moral Resiliency
    • Moral resilience – preserving/restoring integrity
    • Personal vs. professional grieving
    • Enabling character and honorable action
    • Ethical Competency


Nancy E. Joyner is a Palliative Care Clinical Nurse Specialist with prescriptive practice. She is currently self-employed as a consultant, speaker, educator and author. Nancy has gained extensive experience in serious illness, frailty, and end of life care through her 28 years working bedside as a registered nurse and an additional 11 years as an advanced practice nurse with prescriptive practice.

Her commitment to the specialty is seen through furthering her education to become a palliative care Clinical Nurse Specialist, certification as an Advanced Certified Hospice and Palliative Care Nurse serving as an active member on the Hospice and Palliative Nursing (HPNA)'s Professional Development Council and becoming an HPNA Nurse Educator.

Nancy has shared her passionate insights at the local, state, and national levels. She is an ELNEC (End-of-Life Nursing Education Consortium) trained presenter and has taught the national advanced NBCHPN certification review course, and has shared her insights as an online palliative care faculty member.

You are guaranteed to learn from Nancy's passion to deliver extreme compassion, expert communication skills, and extraordinary knowledge to the end of life patients entrusted to your care.

Speaker Disclosures:

Financial: Nancy E. Joyner is CEO and President of Nancy Joyner Consulting, P.C. She receives a speaking honorarium from PESI, Inc.

Non-financial: Nancy E. Joyner has no relevant non-financial relationships to disclose.
Credits listed below are for full attendance at the live event only. Certificates of Completion are distributed at the conclusion of the live seminar for those who register prior to the event date and attend the full day. A letter of attendance will be issued to participants who register at the event, arrive late, or leave early. For those who registered day of (walk-ins), and are in full attendance, a certificate of completion for full CE credit will be sent within 30 days following the event. For those in partial attendance (arrived late or left early), an adjusted certificate of completion reflecting partial credit will be issued within 30 days (if your board allows). Please see “live seminar schedule” for full attendance start and end times. NOTE: Boards do not allow credit for breaks or lunch.

If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, or questions on home study credit availability, please contact or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

PESI, Inc. offers continuing education programs and products under the brand names PESI, PESI Healthcare, PESI Rehab and Psychotherapy Networker.

This seminar qualifies for 1.0 hours of general ethics instruction. If ethics is not specified within your licensing board’s approval statement below, please contact your board to determine the applicability and amount of ethics allowed.

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This course has been awarded 6.25 clock hours by the Commission for Case Manager Certification. Full attendance is required.

This activity is designed to qualify for 6.25 continuing education hours.

This intermediate activity consists of 6.25 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from the activity and contact your state board or organization to determine specific filing requirements.

VIRGINIA COUNSELORS: This intermediate activity consists of 6.25 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please contact your licensing board to determine if they accept programs or providers approved by other national or state licensing boards. A certificate of attendance will be awarded at the end of the program to participants who are in full attendance and who complete the program evaluation.

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PESI, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses in full attendance will earn 6.3 contact hours. PARTIAL CONTACT HOURS WILL BE AWARDED FOR PARTIAL ATTENDANCE.

This program has been reviewed and is approved for a maximum of 6.25 hours of clinical Category I CME credit by the American Academy of Physician Assistant Review Panel. Physician assistants should claim only those hours actually spent participating in the CME activity. This program was planned in accordance with AAPA’s CME Standards for Live Programs and for Commercial Support of Live Programs.

PESI, Inc. Provider #:1062, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB), through the Approved Continuing Education (ACE) Program. PESI, Inc. maintains responsibility for the program. ASWB Approval Period: January 27, 2017 - January 27, 2020. Social workers should contact their regulatory board to determine course approval for continuing education credits. Social workers participating in this course will receive 5.25 (Clinical) and 1.0 (Ethics) continuing education clock hours for completing this Intermediate course. A certificate of attendance will be awarded at the end of the program to social workers who complete the program evaluation. No more than 6.25 total CE hours may be awarded for this activity.

This activity qualifies for 380 minutes of instructional content as required by many national, state and local licensing boards and professional organizations. Save your course outline and certificate of completion, and contact your own board or organization for specific requirements.

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