Southeast Campus

Hospice and Palliative Care

Hospice of the Red River Valley

IMED 9210

Participating Faculty:
Preston D. Steen, M.D.

Offered: All periods

Objectives of the Elective:

Medical students will be responsible for second and third year palliative care curriculum objectives in addition to the following fourth year objectives:

Attitude

  1. Terminal care is best provided by a interdisciplinary team evaluating and managing a patient's care.
  2. The physician must be sensitive to a patient's cultural beliefs, traditions, and rituals even though they may be different than the physician's.
  3. Spiritual, psychological and social support are essential components of care for the terminally ill person and family.

Knowledge

  1. Discuss the different nonpharmacological (psychological and physical) approaches to control symptoms in the terminally ill patient.
  2. Describe the principles of biomedical ethics, including beneficence, nonmalficence, autonomy, competence, informed consent, advance directives, and guidelines for medical decision making for people near the end of life.
  3. Describe the common disorders causing terminal illness, along with their usual disease courses, presentations, and progression.
  4. Identify and quantify the symptoms (pain, nausea/vomiting,constipation, depression, anxiety, confusion, pruritis, anorexia, weakness/fatigue) along with the evaluation necessary for their control in the terminally ill patient.
  5. Understand the rationale for various types of invasive vs. non-invasive palliative measures in selected situations, including: surgery to relieve pain (e.g. bowel obstruction), radiation therapy (e.g. painful bone metasteses), and the various routes of administration of medication to relieve common symptoms such as pain, nausea and/or vomiting, constipation, depression, anorexia, anxiety, and confusion.
  6. Discuss specific regional laws that impact decisions near the end of life. Be aware of narcotic presciption laws.
  7. Distinguish normal and complicated bereavement in order to make appropriate referrals.
  8. Discuss the issues of access to and financing of health care for terminally ill patients in various settings.

Skills

  1. Utilize the interdisciplinary team to manage the patient or family with common psychosocial issues or problems that face the terminally ill patient and his or her family (or care giver).
  2. Treat the dying patient in various settings, showing sensitivity and skill in organizing care responsive to the advantages and disadvantages of the particular environment.
  3. Balance the values of the dying patient, medical factors and environmental factors in medical decision making.
  4. Encourage patient control of as many aspects of life as possible with terminal illness.
  5. Assess a terminally ill patient in multiple relevant dimensions, describing current physical and psychosocial problems, as well as obtaining appropriate information, including social support systems and functional status.

Clinical Experiences to Support the Objectives

One month hospice rotation which provides the following experiences:

Evaluation Procedures