Product Detail

Caring at the End of Life
Online Course
$1,099.95 USD
$299.99 USD
Product Details
Online Course
PESI HealthCare
CE Available:
Yes, See CE credit tab for complete continuing education details
Product Code:
[+] [-] 050235 - Understanding the Needs of the Dying: Bringing Hope, Comfort and Love to Life's Final Chapter
  1. Identify common needs of the dying and ways to meet across many health care settings
  2. Discover ways to discuss end of life issues while allowing miracles and hope
  3. Identify the differences and commonalities of palliative and hospice care models
  4. Define anticipatory grief and how it shapes the end of life experience for patients and families
  5. Gain tools and techniques to manage our own reactions to loss in the workplace
  6. Interpret and resolve conflict regarding advance directives and code status
  7. Describe tools to help children cope with a love one dying
  8. Identify common characteristics of deathbed visions and normalize them for families
  9. Prepare techniques for running a successful family conference
  10. Define how fears about pain addiction can play a role in family dynamics at the end of life
  11. Outline the role of spirituality and its role in the last years of life

[+] [-] 054390 - David Kessler: Finding Meaning:
  1. Develop meaning-making principles to assist clients coping with various types of loss.
  2. Formulate ways to use meaning to help clients remember with more love than pain.
  3. Outline techniques for using meaning to help clients resolve the internal struggle of “why did this happen?” and “why did this happen to me?”
  4. Determine why children are often the forgotten grievers and how to help them through their grief.
  5. Develop strategies that incorporate meaning mechanisms to help clients cope with complicated grieving.
  6. Utilize strategies to help clients address guilt, shame and stigma associated with grief.

[+] [-] 077090 - Care When There is No Cure for Patients with End Stage Diseases
  1. Summarize the assessment scales that are predictive of poor survival.
  2. Explain the importance of prognosis and shared decision-making.
  3. Evaluate the benefits of using palliative care principles for patients with end stage disease.
  4. Distinguish palliative services vs. hospice services.
  5. Choose strategies to help patients overcome the fear of death.
  6. Predict challenging end of life symptoms and the best interventions.

[+] [-] 077560 - Palliative Wound Care:
  1. Differentiate between various palliative-specific wound care treatment interventions.
  2. Select the best strategies to manage drainage, odor, bleeding and wound pain.
  3. Recognize atypical types of wounds and appropriate symptom management for each.
  4. Plan for management challenges that can present with complex fistulas.
  5. Prepare for the emotional and psychological effects of end of life wounds for patients and families.
  6. Appraise symptoms of stress/burnout/ compassion fatigue in your life.

[+] [-] 077635 - Nearing the End of Life:
  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. Analyze five complications related to artificial hydration and nutrition.
  5. Explore ethical issues often seen at the end of life.
  6. Formulate two strategies to diminish fear of death and dying.
  7. Connect moral resiliency to palliative care.

[+] [-] 050235 - Understanding the Needs of the Dying: Bringing Hope, Comfort and Love to Life's Final Chapter
Signs of Impending Death
  • Preparing family for physical changes
  • Interventions for coping with emotional changes in the family
  • Using near death awareness as a predictor in clinical settings
Palliative Care Model
  • Academic settings vs community
  • Physician led vs non physician led
  • Roles of physician, nurse, social worker, case manager, discharge planner, clergy
  • What’s best - hospital, home health, hospice, skilled nursing facility
  • Joint commission certification
  • Removing barriers
  • How hospice can increase length of stay while decreasing hospital time
  • Bereavement services to enhance community partnerships
Death Related Sensory Experiences (Death Bed Visions)
  • Effective and ineffective models for family coping and integration
  • Religion in patients’ deathbed visions
  • Using the law to normalize the dying experience
  • Clinical/palliative care studies, research of near death awareness
Advance Directives
  • Physician order for life sustaining treatment
  • Make advance directives useful and medically effective
  • D.N.R. (do not resuscitate) vs. A.N.D.(allow natural death)
  • Code status and impact on the grieving process
Anticipatory Grief
  • Treatment strategies for hospice, palliative care and mental health care professionals
  • Tools for normalizing
Helping the Dying Patient’s Children
  • How the media shapes a child’s view of death
  • Tools for preparing a child for loss
  • Interventions for coping with funerals
  • Why children are often the forgotten grievers and how to help
The Ethics Committee and End of Life
  • How and when to use your ethics committee
  • How and why members of the end of life team can participate
  • Techniques for helping families get the most out of the ethics meetings
  • Avoid the common pitfalls of ethics committees at the end of life
Hope and Miracles
  • How to help families integrate desire for miracles at the end of life
  • Techniques for honoring hope without fostering denial
Cultural Differences
  • Affecting care of the dying
  • Tools for successfully bridging the gap with healthcare providers and families
The Question of Assisted Suicide
  • Understanding the current debate
  • The realities of withdrawing care vs assisted suicide
  • Learn techniques for addressing patient’s requests for assisted suicide within the facilities and health care provider’s beliefs system

[+] [-] 054390 - David Kessler: Finding Meaning:
The Sixth Stage of Grief: Finding Meaning
  • Why the stages were never meant to be linear
  • What is meaning making in grief?
  • Types of meaning making
  • How meaning can help remember the person who died with more love than pain
  • Why a sixth stage is the key to recovery from grief
  • Keys to finding acceptance and moving into the sixth stage
Witnessing vs. “Fixing” Grief
  • Mirroring techniques
  • The cost of trying to “fix” those who are grieving
  • Go beyond active listening skills to connect
  • The consequence of trying to find meaning too early
Help Clients Change Their Thinking Around Loss
  • Non-directive ways to address guilt, shame and stigma in grief
  • How to increase resilience and the possibility for posttraumatic growth after loss
  • Understand the “meaning” we attach to the traumatic loss or death
  • Decrease catastrophizing after loss Learn ways to instill good memories instead of painful ones
Complicated Grief
  • Simplifying grief models and exploring new models, including resiliency and Option B
  • Meaning making as a new tool for dealing with murder, multiple losses, Alzheimer’s
  • Post-traumatic growth vs. post-traumatic trauma
  • Help release obsessive replaying of the trauma/death
Help Bereaved Parents
  • Understanding the impact of child loss
  • Learn ways to be comfortable working with this type of loss
  • Supporting parents who are often grieving differently
  • Help parents sustain the marriage through tremendous loss
  • Navigating the discomfort of living and loving again
  • Address intimacy issues that may come up in grief
The Grief of Suicide
  • Overcoming the “what if’s” and “if only’s”
  • Understand the true “why” of death by suicide
  • Ways to help others find peace again
Loss by Addiction
  • Meaning making for healing self-blame
  • How to help loved ones sort through the shame and isolation
  • Understanding the role they did and didn’t play in an addiction death
Shootings and Other Disasters
  • Shootings/hurricanes/earthquakes and terrorist acts
  • Guidelines for approaching horrific crime and/or disaster scenes
  • The impact of natural vs. manmade disasters
Healing Complicated Relationships after Death
  • Understand patterns that can heal that relationship and help in all future relationships
  • Learn ways to help find peace in difficult relationships
Death and Dying
  • How hospice and palliative care professionals can facilitate meaning making
  • Understand how the death shapes the grief
  • Re-interpret the meaning behind false end-of-life beliefs
  • Why meaning can be the key to a “good” death
Meaning and the Afterlife
  • Effective and ineffective models of continuing connections for living a full life
  • Use the model of continuing bonds and connections for healing
  • Normalize experiences around continued connections with loved ones who have died

[+] [-] 077090 - Care When There is No Cure for Patients with End Stage Diseases

Disease Prognostication: An Inexact Art & Science

  • Individualized care: The importance of prognosis (science/art/intuition)
  • Determining palliative care vs. hospice care
  • Crucial conversations
  • The hospice benefit

?Congestive Heart Failure: The Broken Heart

  • Best practice: The Seattle HF Model
  • Medication management strategies
  • Symptom management and pain management
  • Pacemakers, ICDs & LVADs - Living better or prolonging suffering?

Chronic Obstructive Lung Disease

  • Global Obstructive Lung Disease (GOLD) Guidelines
  • The COPD Assessment Test (CAT)
  • Treating dyspnea: "The Pain of Non-Malignant Disease"
  • The medication tool box: Oxygen, bronchodilators, opioids and steroids

Renal Disease

  • Appropriate use of dialysis
  • Staging disease with Glomerular Filtration Rate
  • Hemodialysis mortality predictor
  • Symptom burden
  • Underutilization of hospice
  • Opiods with dialysis

Liver Disease

  • Indicators of poor prognosis
  • Differentiating when cirrhosis is the cause
  • Most useful analgesics for the pain
  • Waiting for transplant while on hospice: Use of the MELD tool

Advanced Dementia

  • Pain scales
  • Feeding tube dilemmas - and outcomes
  • Delirium and dementia: Interventions for agitation and aggression
  • End state dementia

Amyotrophic Lateral Sclerosis

  • Diagnostic tests for ALS
  • Advance directives and life support decisions
  • Nutrition and gastrostomy
  • Non–invasive ventilation
  • Table of useful medications and palliative measures

Advanced Cancer

  • The value of early palliative care
  • Spiritual needs
  • Complications and interventions
    • Spinal cord compression
    • Superior vena cava syndrome
    • Bowel obstruction
    • Hypercalcemia
    • Fungating wound/terminal Kennedy ulcer

Eight Signs of Impending Death

Challenging Decisions

  • What do people want at the end of life?
  • Delirium vs. near death awareness
  • Mental health needs of the dying
  • Palliative sedation therapy for intractable symptoms
  • Does the dying person need hydration? Oxygen? Treatment for rales?

Moral Distress

  • Uncomfortable patient/family scenarios
  • Ethical dilemmas
  • Medication errors
  • Conflicted consciences

[+] [-] 077560 - Palliative Wound Care:
  • The Infected Wound
    • Contamination, Colonization and Infection
    • Optimal Culturing for an Infected Wound
    • Reducing Unnecessary Antibiotic Usage
    • Reducing Biofilms
  • Impact of Nutrition/Labs
    • Prealbumin vs. Albumin - and What to Do with the Results
    • Glycemic Control and Wound Healing
    • Ways to Enhance Nutritional Intake
  • Choosing a Debridement Method
    • Autolytic
    • Enzymatic
    • Mechanical
    • Conservative Sharp
    • Maggot Therapy
  • Wound Types and Etiologies
    • Pressure Ulcers and Staging
      • Pressure… Seeing the Tip of the Iceberg
      • Tools for Predicting Pressure Ulcer Risk
      • Early Detection of Deep Tissue Injury
      • Incontinences Associated Dermatitis vs. Pressure Ulcers
    • Venous Stasis Ulcers
      • Where is All This Fluid Coming From?
      • Lymphedema
      • Feeling the Squeeze… Different Degrees of Compression
    • Arterial Ulcers
      • Arterial Perfusion
      • Claudication and Rest Pain
      • Diagnostic Tests: Vascular Studies and ABIs
    • Diabetic/Neuropathic Ulcers
      • Assessing Sensation
      • Bad to the Bone… Osteomyelitis
    • Skin Tears/ Adhesive Injuries
      • Is it Partial or Full Thickness Loss?
      • Managing Xerosis with Products in Your Kitchen!
      • Moisturizing and Skin pH…
  • Time Out: Identify Wound Types Through Actual Patient Pictures
    • Making Sense of the Endless Dressing Options
      • Foams
      • Alginates and Hydrofiber
      • Hydrogels
      • Thin Films
      • Negative Pressure Wound Therapy
      • The Magic of Honey
      • Contact Layers
      • Alternative Homeopathic Approaches to Wound Care
  • Hands-On Intensive Interactive Session: Wound Products & Homeopathic Treatments
    • Management of End of Life Wounds
      • Managing Drainage
      • Bleeding and Use of Monsels Solution
      • Odor and Use of Metronidazole
      • Disfigurement and Loss of Being Touched
    • Skin Failure
      • How to Recognize It
      • How to Document It
      • How to Explain to Caregivers What’s Happening
    • Recognizing Atypical Wounds
      • Management of Fungating/Malignant Wounds
      • Calciphylaxis
      • Pyoderma Gangrenosum
      • Kennedy Ulcerations
      • Pruritis and Xerosis
  • Time Out: Management of Unavoidable Wounds & Actual Patient Scenario Discussion
    • Fistula Solutions
      • Containment of Effluent and Odor
      • Protecting Surrounding Tissue
      • Fistula Containment Management System: Hands-On Fistula Management Systems
    • Understanding Wound Pain and Treatment Options
      • What Type of Pain is it?
      • Reducing Pain with Dressing Changes/Wound Care
      • Use of Topical Opioids for Wound Pain
    • Documentation Strategies for Unavoidable Wounds
      • Describing Patient Function and Charting Patient Decline
      • Documenting Prevention Strategies
      • Discussing Realistic Outcomes with Patient and Family
      • Avoiding Wound Care Litigation
    • Burnout vs. Compassion Fatigue
      • Identifying Your Own Stress and Anxiety
      • Seeing Suffering Every Day
      • How Stress & Guilt Affect Your Body
      • Developing Resilience
      • Maintaining a Sense of Hope
  • Life Balance Exercise: Building A Personal Resiliency Plan

[+] [-] 077635 - Nearing the End of Life:
  • 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



David Kessler is one of the world’s foremost experts on healing and loss. His experience with thousands of people on the edge of life and death has taught him the secrets to living a happy and fulfilled life.

He is the author of six bestselling books. His new book is Finding Meaning: The Sixth Stage of Grief. His first book, The Needs of the Dying, a #1 best-selling hospice book, received praise by (Saint) Mother Teresa. He co-authored two bestsellers with the legendary Elisabeth Kübler-Ross: On Grief and Grieving and Life Lessons. His most newly released book is You Can Heal Your Heart: Finding Peace After Breakup, Divorce or Death with Louise Hay. He worked with Elizabeth Taylor, Jamie Lee Curtis, and Marianne Williamson when their loved ones faced life-challenging illnesses. He also worked with late actors Anthony Perkins and Michael Landon. David’s work has been discussed in the Los Angeles Times, Business Week and Life Magazine, and has been featured on “Brené Brown, CNN-Cross Fire”, NBC, Fox, PBS, “Dr. Oz” and “Entertainment Tonight”. David is a contributing writer on, Dr. Oz’s, “Anderson Cooper 360” and “The Huffington Post”.

David has a master’s degree in Health Care Bioethics from Loyola Marymount University, he did his undergraduate work at University of Southern California and is a member of the American College of Health Care Executives. He is a certified AMA/EPEC (Education for Physicians) trainer. He also is the founding chairperson for the Hospital Association of Southern California Palliative Care Committee and spent the last decade as a C-suite executive in a 650 bed – three hospital system in Los Angeles County.

Speaker Disclosures:

Financial: David Kessler is president of David Kessler, Inc. He is an author for Simon & Schuster – New York and receives royalties. Mr. Kessler receives a speaking honorarium from PESI, Inc.

Non-financial: David Kessler has no relevant non-financial relationship to disclose.


Lores Vlaminck, RN, BSN, MA, CHPN, is a consultant for home care, palliative care, hospice, and assisted living providing education, training, mock surveys, and mentoring for staff development. Lores’ extensive professional nursing experiences span clinical practice in cardiac and intensive care, outpatient clinical services and as a founder/director of a Medicare certified home care/hospice director in greater MN. Her role in the ‘trenches’ gives her a unique understanding of the challenges and opportunities professionals and volunteers face in accompanying the patient and family facing a serious or life-limiting illness.

Lores offers state and national education on palliative and hospice care and is certified trainer of the ELNEC (End-of-Life Nursing Education Consortium) modules, EPEC (Education on Palliative and End-of-Life Care) modules and the HPNA’s (Hospice and Palliative Care Nurses Association) curriculum. She is a member of MHCA (Minnesota Home Care Association), MNHPC (Minnesota Network for Hospice and Palliative Care), Leading Age MN, NHPCO (National Hospice and Palliative Care Organization), HPNA (Hospice Palliative Nursing Association- MN Chapter) and Sigma Theta Tau. Additionally, Lores also serves on two not-for-profit long-term care boards.

Through a blend of both grief and joy filled patient stories, clinical expertise and referenced material, Lores will be sure to engage you at both an intellectual and heart level. Participants across the country have consistently shared that Lores’ humility, honesty, humor and genuine compassion allow for permission to ‘feel what is felt’.

Speaker Disclosures:

Financial: Lores Vlaminck is Principal for Lores Consulting. She receives a speaking honorarium from PESI, Inc.

Non-financial: Lores Vlaminck has no relevant nonfinancial relationship to disclose.


Laurie Klipfel, RN, MSN, ANP-BC, CDE, has been a Certified Diabetes Educator for over 20 years and has managed several hospital ADA-recognized diabetes education programs; she is a Board-Certified Adult Nurse Practitioner with a specialty in endocrinology and a certification in wound care. A member of the American Association of Diabetes Educators, Laurie is the past president of her local chapter. Laurie works at a large hospital in St. Louis, MO, serving the needs of patients with diabetes in both inpatient and outpatient settings.

Laurie is also a certified insulin pump trainer and has published articles on the use of insulin pumps for hospitalized patients. Her practical patient experiences, supported by clinical knowledge, provide a blend of information on how to treat diabetes today. Her goal is to provide the current strategies and treatments you need to improve the outcomes of your patients. Speaker Disclosures:

Financial: Laurie Klipfel has an employment relationship with St. Clare Hospital. She receives an honorarium from the American Association of Diabetes Educators. Ms. Klipfel receives a speaking honorarium from PESI, Inc.

Nonfinancial: Laurie Klipfel is a member of the Association for Size Diversity and Health (ASDAH).


Nancy Joyner is recognized nationally as a palliative care educator, speaker, nurse consultant and author. She is a Palliative Care Clinical Nurse Specialist with over 38 years of nursing experience. Nancy holds certification as an Advance Certified Hospice and Palliative Care Nurse, one of only three in North Dakota. Nancy has gained extensive nursing proficiency from neonatal, pediatric, home care and hospice areas to palliative care provision in almost all departments of hospital and outpatient settings, including the clinic and long-term care. She is the past president of Honoring Choices® North Dakota and active in North Dakota's Palliative Care Task Force. Nancy is the palliative care subject matter expert for UND Center for Rural Health's rural community-based palliative care project. She is a Hospice and Palliative Nurses Association Certified Nurse Educator and Respecting Choices® First Steps Advance Care Planning Instructor. Nancy has developed and taught online palliative care courses for the University of North Dakota and Bemidji State University. She is a nationally certified ELNEC (End-of-Life Nursing Education) trainer as well as a nationally trained POLST trainer.

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.
Continuing Education Credits Awarded for Completion of Entire Package
[+] [-] Combined Continuing Education Credit From All Components
Breakdown of Continuing Education Credits by Components
[+] [-] 050235 - Understanding the Needs of the Dying: Bringing Hope, Comfort and Love to Life's Final Chapter
[+] [-] 054390 - David Kessler: Finding Meaning:
[+] [-] 077090 - Care When There is No Cure for Patients with End Stage Diseases
[+] [-] 077560 - Palliative Wound Care:
[+] [-] 077635 - Nearing the End of Life:
Psychologists, Counselors, Social Workers, Case Managers, Marriage & Family Therapists, Nurses, Chaplains/Clergy and other Mental Health Professionals ,
  • Counselors
  • ,
  • Social Workers
  • ,
  • Psychologists
  • ,
  • Physicians
  • ,
  • Marriage & Family Therapists
  • ,
  • Nurses
  • ,
  • Case Managers
  • ,
  • Addiction Counselors
  • ,
  • Thanatologists
  • ,
  • Chaplains/Clergy Hospitals
  • ,
  • Palliative Care Professionals
  • ,
  • Hospice Professionals
  • ,
  • Funeral Directors
  • ,
  • Other Mental Health and Bereavement Professionals
  • ,
  • Nurse Practitioners
  • ,
  • Clinical Nurse Specialists
  • ,
  • Chaplains
  • ,
  • Clergy
  • , Physician Assistants, Physical Therapists, Nursing Home Administrators