Category

Advance Directives

Surrogate Challenges Can Overwhelm Even An Experienced Hospice RN

By | Advance Directives, Dementia, Disability, Dying, End-of-life care, Funeral Planning, Grief, Mental Illness, Surrogate | 2 Comments

“Sleep deprivation amplified every emotion and wore me down quickly,” she said. She was exhausted, angry, and felt guilty. She was “flying blind” to be the surrogate as Betty neared death – and she was a trained, experienced hospice RN. What does that say about your chance of being an effective surrogate?

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Improving End-of-Life Family Meetings Part 3

By | Advance Directives, Choice, Dying, End-of-life care, Funeral Planning, Suffering and Death, Surrogate | One Comment

As discussed in Part 2, the SPIKES framework is useful to explore the family’s understanding of their loved one’s illness and to share information about medical condition and prognosis. When the purpose of a family meeting is to discuss goals of care, it may be useful to “unpack” care goals using the REMAP framework.

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Improving Family End-of-Life Discussions Part 1

By | Advance Directives, Choice, Dying, End-of-life care, Funeral Planning, Suffering and Death, Surrogate | 4 Comments

Timely, well-conducted conversations about goals of care in serious illness are associated with improved outcomes, including care aligned with the ill person’s values, less unwanted (and often expensive) care, improved satisfaction with care, and fewer mental health consequences for patients and families.

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