End-of-Life Goals and Perspectives - A Thoughtful Exploration
Explore the importance of end-of-life goals and perspectives through a Jeopardy-style format. Learn about reframing care approaches, honoring individual values, and fostering hope during challenging times.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
At the End of Life Trisha K. Paul, MD Courtesy of Eric Curts This slideshow is licensed under a Creative Commons Attribution Non-Commercial 3.0 United States license. For more information about this license see http://creativecommons.org/licenses/by-nc/3.0/ (In short, you can copy, distribute, and adapt this work as long as you give proper attribution and do not charge for it.)
EOL JEOPARDY FINAL JEOPARDY FINAL JEOPARDY EOL JEOPARDY Quality of Life Health Inequity Goals Ethics Faith $100 $100 $100 $100 $100 $200 $200 $200 $200 $200 $300 $300 $300 $300 $300 $400 $400 $400 $400 $400 $500 $500 $500 $500 $500
Goals - $100 Question What are some things you want to know about what matters to a person about how they die before they are sick? Goals - $100 Question What are some things you want to know about what matters to a person about how they die before they are sick? Click to see answer Click to see answer
Goals - $100 Answer Live as long as possible vs. Live as well as possible vs. a combination (live as long and as well as possible) Differs for each individual Goals - $100 Answer Live as long as possible vs. Live as well as possible vs. a combination (live as long and as well as possible) Differs for each individual Click to return to Jeopardy Board Click to return to Jeopardy Board
Goals - $200 Question How might you reframe the idea of doing everything for a patient who might be nearing the end of life? Goals - $200 Question How might you reframe the idea of doing everything for a patient who might be nearing the end of life? Click to see answer Click to see answer
Goals - $200 Answer We are going to do everything to help you and nothing to harm you Goals - $200 Answer We are going to do everything to help you and nothing to harm you Click to return to Jeopardy Board Click to return to Jeopardy Board
Goals - $300 Question Hope: How did Dr. Zutter respond when the daughter spoke about her hopes for a miracle? What effect did it have on the daughter? Goals - $300 Question Hope: How did Dr. Zutter respond when the daughter spoke about her hopes for a miracle? What effect did it have on the daughter? Click to see answer Click to see answer
Goals - $300 Answer Hope together. Don t take away someone s hope; instead align and share their hope with them. We never give up hope. We just change what we are hoping for ie. no suffering. Goals - $300 Answer Hope together. Don t take away someone s hope; instead align and share their hope with them. We never give up hope. We just change what we are hoping for ie. no suffering. Click to return to Jeopardy Board Click to return to Jeopardy Board
Goals - $400 Question Goals - $400 Question How can we effectively elicit patient goals and values? Think about what you saw done in Extremis. How can we effectively elicit patient goals and values? Think about what you saw done in Extremis. Click to see answer Click to see answer
Goals - $400 Answer Learn a person s story. What they value, what they enjoy, what matters most to them, what they have shared previously about their perspective on quality of life Goals - $400 Answer Learn a person s story. What they value, what they enjoy, what matters most to them, what they have shared previously about their perspective on quality of life Click to return to Jeopardy Board Click to return to Jeopardy Board
Goals - $500 Question Goals - $500 Question True or false: patients experience starvation if they are not given nutrition when dying. True or false: patients experience starvation if they are not given nutrition when dying. Click to see answer Click to see answer
Goals - $500 Answer False: the dying body does not need nutrition. Artificial nutrition via feeding tubes can prolong dying process. (hard for families since in many cultures, food = love) Goals - $500 Answer False: the dying body does not need nutrition. Artificial nutrition via feeding tubes can prolong dying process. (hard for families since in many cultures, food = love) Click to return to Jeopardy Board Click to return to Jeopardy Board
Quality of Life - $100 Question An approach to care for patients with life-limiting illness (less than 6 months life expectancy) Quality of Life - $100 Question An approach to care for patients with life-limiting illness (less than 6 months life expectancy) Click to see answer Click to see answer
Quality of Life - $100 Answer Quality of Life - $100 Answer Hospice Hospice Click to return to Jeopardy Board Click to return to Jeopardy Board
Quality of Life - $200 Question Quality of Life - $200 Question What makes your life worth living? What makes your life worth living? Click to see answer Click to see answer
Quality of Life - $200 Answer Quality of Life - $200 Answer Everyone can share in a few words what comes to mind Everyone can share in a few words what comes to mind Click to return to Jeopardy Board Click to return to Jeopardy Board
Quality of Life - $300 Question What does a good day look like for a parent or grandparent in your life? Quality of Life - $300 Question What does a good day look like for a parent or grandparent in your life? Click to see answer Click to see answer
Quality of Life - $300 Answer Quality of Life - $300 Answer Everyone can share in a few words what comes to mind Everyone can share in a few words what comes to mind Click to return to Jeopardy Board Click to return to Jeopardy Board
Quality of Life - $400 Question How might you reframe the narrative of someone saying that your loved one needs a tracheostomy tube or a feeding tube? Quality of Life - $400 Question How might you reframe the narrative of someone saying that your loved one needs a tracheostomy tube or a feeding tube? Click to see answer Click to see answer
Quality of Life - $400 Answer Reframe medical decision-making for patient care to align with patient goals rather than assuming life prolongation Quality of Life - $400 Answer Reframe medical decision- making for patient care to align with patient goals rather than assuming life prolongation Click to return to Jeopardy Board Click to return to Jeopardy Board
Quality of Life - $500 Question How does medicine draw a line about what quality of life if unacceptable? Quality of Life - $500 Question How does medicine draw a line about what quality of life if unacceptable? Click to see answer Click to see answer
Quality of Life - $500 Answer Quality of Life - $500 Answer Based on what is considered harm, or when risks>benefits. Ie. neurologic injury, possibility for meaningful recovery and healing, as well as patient/family goals Based on what is considered harm, or when risks>benefits. Ie. neurologic injury, possibility for meaningful recovery and healing, as well as patient/family goals Click to return to Jeopardy Board Click to return to Jeopardy Board
Ethics - $100 Question Who was shown on the Extremis documentary that maybe should not have been included on camera? Ethics - $100 Question Who was shown on the Extremis documentary that maybe should not have been included on camera? Click to see answer Click to see answer
Ethics - $100 Answer The patients who did not have decision-making capacity Ethics - $100 Answer The patients who did not have decision-making capacity Click to return to Jeopardy Board Click to return to Jeopardy Board
Ethics - $200 Question How should we decide if a person has decision-making capacity? Ethics - $200 Question How should we decide if a person has decision-making capacity? Click to see answer Click to see answer
Ethics - $200 Answer Decision-making capacity is based on neurologic status as well as 4 conditions: understanding, appreciation, reasoning, expression of a choice Ethics - $200 Answer Decision-making capacity is based on neurologic status as well as 4 conditions: understanding, appreciation, reasoning, expression of a choice Click to return to Jeopardy Board Click to return to Jeopardy Board
Ethics - $300 Question Ethics - $300 Question Who should make decisions about a patient s end of life? Who should make decisions about a patient s end of life? Click to see answer Click to see answer
Ethics - $300 Answer It depends! The patient, but this is influenced by culture, family, and physician guidance. Ethics - $300 Answer It depends! The patient, but this is influenced by culture, family, and physician guidance. Click to return to Jeopardy Board Click to return to Jeopardy Board
Ethics - $400 Question Ethics - $400 Question Is it ethical to stop therapies that are life-prolonging? Is it ethical to stop therapies that are life-prolonging? Click to see answer Click to see answer
Ethics - $400 Answer Ethics - $400 Answer Yes. Discontinuation of life-sustaining treatments is ethical because it allows rather than causes natural death. Similar to never starting an intervention in the first place. Yes. Discontinuation of life- sustaining treatments is ethical because it allows rather than causes natural death. Similar to never starting an intervention in the first place. Click to return to Jeopardy Board Click to return to Jeopardy Board
Ethics - $500 Question What should be the process for making care decisions for a person who lacks decision-making capacity and does not have a surrogate decision-maker? Ethics - $500 Question What should be the process for making care decisions for a person who lacks decision- making capacity and does not have a surrogate decision-maker? Click to see answer Click to see answer
Ethics - $500 Answer Multiple independent decision-makers vs. court-appointed (varies by state). Best interest standard Ethics - $500 Answer Multiple independent decision-makers vs. court- appointed (varies by state). Best interest standard Click to return to Jeopardy Board Click to return to Jeopardy Board
Faith - $100 Question Should doctors talk about religion with their patients? Why or why not? Faith - $100 Question Should doctors talk about religion with their patients? Why or why not? Click to see answer Click to see answer
Faith - $100 Answer Research shows that many patients wish their doctors would bring up faith, but less than 4% do Faith - $100 Answer Research shows that many patients wish their doctors would bring up faith, but less than 4% do Click to return to Jeopardy Board Click to return to Jeopardy Board
Faith - $200 Question Hospitals and hospices have these people to provide specialized non-denominational-specific spiritual care Faith - $200 Question Hospitals and hospices have these people to provide specialized non- denominational-specific spiritual care Click to see answer Click to see answer
Faith - $200 Answer Faith - $200 Answer Chaplains Chaplains Click to return to Jeopardy Board Click to return to Jeopardy Board
Faith - $300 Question How should medicine respond when people are hoping for miracles? Faith - $300 Question How should medicine respond when people are hoping for miracles? Click to see answer Click to see answer
Faith - $300 Answer Faith - $300 Answer We hope alongside them, AND worry about xyz. Ie. We hope for the best AND try to prepare for the worst. We hope alongside them, AND worry about xyz. Ie. We hope for the best AND try to prepare for the worst. Click to return to Jeopardy Board Click to return to Jeopardy Board
Faith - $400 Question If someone believes that talking/thinking about dying is sinful because doing so expresses doubt, how should clinicians personalize their approach to better support them? Faith - $400 Question If someone believes that talking/thinking about dying is sinful because doing so expresses doubt, how should clinicians personalize their approach to better support them? Click to see answer Click to see answer
Faith - $400 Answer Patients who are unable to verbalize fears due to their beliefs might benefit from a more direct rather than open-ended shared decision-making approach if a patient is sick Faith - $400 Answer Patients who are unable to verbalize fears due to their beliefs might benefit from a more direct rather than open-ended shared decision- making approach if a patient is sick Click to return to Jeopardy Board Click to return to Jeopardy Board
Faith - $500 Question If someone says that they are hoping/praying for a miracle, does that mean that they do not understand the severity of what is going on? Faith - $500 Question If someone says that they are hoping/praying for a miracle, does that mean that they do not understand the severity of what is going on? Click to see answer Click to see answer
Faith - $500 Answer Faith - $500 Answer Not necessarily. It is possible (and quite natural) to hold two truths at the same time. We hope AND we worry/fear Not necessarily. It is possible (and quite natural) to hold two truths at the same time. We hope AND we worry/fear Click to return to Jeopardy Board Click to return to Jeopardy Board
Health Inequity - $100 Question Health Inequity - $100 Question On average, how much does a funeral cost? On average, how much does a funeral cost? Click to see answer Click to see answer
Health Inequity - $100 Answer Health Inequity - $100 Answer About $8,000 About $8,000 Click to return to Jeopardy Board Click to return to Jeopardy Board
Health Inequity - $200 Question Health Inequity - $200 Question Name 3 disparities in care that exist at the end of life? Name 3 disparities in care that exist at the end of life? Click to see answer Click to see answer
Health Inequity - $200 Answer Health Inequity - $200 Answer Worse pain management Ineffective communication with clinicians Increase family/caregiver burden 1.Worse pain management 2.Ineffective communication with clinicians 3.Increase family/caregiver burden Click to return to Jeopardy Board Click to return to Jeopardy Board
Health Inequity - $300 Question Health Inequity - $300 Question Approximately what percent of hospice patients are black and what percent are white? Approximately what percent of hospice patients are black and what percent are white? Click to see answer Click to see answer
Health Inequity - $300 Answer Health Inequity - $300 Answer 8% black >80% white 8% black >80% white Click to return to Jeopardy Board Click to return to Jeopardy Board
Health Inequity - $400 Question List 6 patient populations that are known to experience suffer disproportionately in the face of serious illness Health Inequity - $400 Question List 6 patient populations that are known to experience suffer disproportionately in the face of serious illness Click to see answer Click to see answer
Health Inequity - $400 Answer Health Inequity - $400 Answer black patients LatinX/hispanic patients Indigenous communities LGBTQIA+ patients Rural communities Low income communities 1.black patients 2.LatinX/hispanic patients 3.Indigenous communities 4.LGBTQIA+ patients 5.Rural communities 6.Low income communities Click to return to Jeopardy Board Click to return to Jeopardy Board
