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Overview of End-of-Life Care

presented by Patty Warring & Lu Krieger-Blake LCSW

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This course gives nurses, therapists, and social workers an overview of hospice care, relevant to practice in multiple settings—including rehabilitation, acute care, long-term care, home health care, and assisted living. The course includes a description of the hospice philosophy of comfort versus cure, criteria for hospice care, the team approach to providing care, the services provided to patients/families by hospice teams, and payment sources. Learners will receive information about the referral process, advance care planning, and guidelines for various disease conditions appropriate for hospice care.

Meet Your Instructors

  • Patty Warring, RN, MSN, ACHPN

    Patricia Warring has been a registered nurse since graduating from Missouri Western State College in 1990 with a BSN degree. She earned an MSN from Valparaiso University in the clinical nurse specialist role, adult health. Patricia’s clinical nursing experience includes five years of medical/surgical/oncology in an acute care setting in the role of staff nurse and supervisor. The past 23 years have been spent as a hospice/palliative care nurse in both in-home and in-patient settings. She has a special passion for pain and symptom control for these patients. Her interest in this area has led her to develop and present educational courses for nurses and staffs at a local, state, and national level. She has co-authored a chapter in a national award winning gerontology textbook on end-of-life care based on competencies in nursing. Patricia was a certified Hospice Specialist for 16 years. She currently serves as adjunct faculty at a local university.

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  • 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 strong believer in the team concept of providing whole person medical care, she promoted clinical teamwork among co-workers in the hospice setting. She educated and inspired multiple teams to understand family dynamics and patient/family adjustments to end of life. During Lu’s hospice tenure, she obtained her MSW degree while working full-time. She was privileged to use her expertise by spreading the word about concepts of hospice care to the community, and to many university classes. Professors often scheduled her to introduce hospice as their new semester began, year after year! She became a sought-after mentor for many social work students from three different local universities who wished to explore the medical field by interning in hospice and later in gerontological care. Student reviews gave her high praise for the quality of her mentoring and their experiences under her direction. Upon retirement from hospice, Lu continued her heart’s mission by bringing her compassionate skills to a non-profit retirement community. She counseled residents and families going through end-of-life experiences that usually preceded the need for hospice care, but the issues of loss and physical decline remained similar and relevant. She continues speaking in the community and has continued to educate about hospice care and family adjustments at end of life by writing chapters in several editions of an award-winning gerontological nursing textbook and now through Medbridge courses.

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Chapters & Learning Objectives

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  1. Hospice Philosophy

    1. Hospice Philosophy

    Professional care staff, including nurses, therapists, and social workers need knowledge of the hospice philosophy of care because patients in many settings will face the need for end-of-life choices. This chapter covers the hospice philosophy and a brief history of the hospice movement, as well as its growth from a volunteer/grass roots program to a mainstream component of medical care in the US.

  2. Advance Care Planning

    2. Advance Care Planning

    Professional care staff need to recognize that they may be involved in difficult discussions with patients and families related to disease progression and decline. They may also be required to educate a patient and family about choices for ongoing care. Hospice could be one of these choices. Advance care planning is inherent to development of a patient/family driven plan of care. This chapter will discuss the documents by which patients may legally define their wishes.

  3. Role of Hospice Care and the Referral Process

    3. Role of Hospice Care and the Referral Process

    Professional care staff will learn about the services provided by hospice including the team approach, inclusion of family as the unit of care, and the roles of the various disciplines in implementing care. The financial coverage of medications related to the terminal illness, equipment to enhance comfort, and respite and inpatient care will also be explained. Medicare and most insurance plans now cover hospice care.

  4. Admission Criteria

    4. Admission Criteria

    Nurses, therapists, and social workers will be given a brief overview of various diseases, which are typically appropriate for hospice care. General guidelines provided by Medicare will be explored for the diseases that are often referred to hospice for end-of-life care. The referral process requires contact with the hospice agency as well as inclusion of the patient’s physician and the hospice medical director.