End of Life Care

All participants will have completed the level one End of Life care Training sessions on Elearning for healthcare: https://www.e-lfh.org.uk/programmes/end-of-life-care/

You need to register to the eLearning for Healthcare platform to be able to access these training. (How to register: https://support.e-lfh.org.uk/get-started/registration/#1601)

Key:

• Blue – Suitable for ALL staff groups
• Black – Registered health and Social care staff E.G RB physiotherapists OT social workers SALT dietician paramedic pharmacist and junior Dr
• Red – Band 6 RN and Above
• Green – Doctors and Prescribers

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TRAINING PROGRAMME (There are 4 headings with a number of sessions listed below. Each session, can be accessed by following module and section names provided next to it; by using the main link.)

a) Communication skills

i) Learning objectives

• • Be able to communicate with a range of people on a range of matters in a from that is appropriate to them and their situation being mindful of the need to talk openly and honestly.
  • Be confident when listening to individuals and those important to them about their concerns related to end of life care and provide appropriate information and support in response.
  • Be able to communicate in a way that ensures information is clear , nonjargonsitic so that it can be fully understood by everyone
  • Have the confidence to communicate with Individuals, and those important to them in a sensitive and flexible manner, demonstrating awareness of the impact of death, dying and bereavement and recognising that their priorities and ability to communicate will vary over time.
  • Have the ability to work with colleagues to share information appropriately and clearly taking account of confidentially to ensure individuals receive the best possible care.
  • Have the ability to explain to an individual’s family member or friend what to do at the time of the persons death and after the death.
  • Be aware of and understand the reach and limitations of local support services that can support individuals and their families thought this period and into bereavement.
  • Have the confidence and skill to sensitively communicate ( taking account to confidentially) with other residents around the health/death of an individual in a group care setting
  • Be able to reflect on your own needs for support when providing EoLC. Identifying a range of things which will support and maintain your own well being

ii) e-learning for healthcare modules

• • Skills which facilitate good communication – (Communication skills 03_02 Basic skills)
  • Understanding and using empathy – (Communication skills 03_03 Communicating with empathy)
  • Things which block good communication – (Communication skills 03_02 Basic skills)
  • Information giving – (Communication skills 03_05 Specific contexts)
  • Breaking bad news (Band 6 and above and DR ) – (Communication skills 03_05 Specific contexts)

b) Advance care planning

i) Learning objectives

• • Be able to identify a range of prognostic indicators for specific conditions which support the recognition that the individual is in the last months of life
  • Be able to describe the signs and symptoms that might indicate that the individual may be entering the last 6-12 months of life
  • discuss the person-centred approach and its relevance to advance care planning (ACP)
  • describe the role of cultural and spiritual factors within the ACP process
  • reflect upon your own core values and how they may impact on how you might interact with patients who have very different wishes and preferences
  • analyse case studies which illustrate the influence of personal, spiritual and cultural factors in ACP
  • discuss the contribution of the multidisciplinary team in highlighting patients’ personal, cultural and spiritual needs
  • Be able to describe the legislation related to mental capacity act (2005) and how it impacts on the care you deliver
  • Be able to explain the legal and ethical framework for DNACPR decision

ii) e-learning for healthcare modules

• • End-of-life care in care homes and domiciliary care settings – (Social care)
  • Introduction to Living with Dementia/Dementia Awareness – (Wellbeing and Mental Health (PWP) Dementia Introduction to Living with Dementia)
  • End of Life Dementia Care – (Wellbeing and Mental Health (PWP) > Dementia > Dementia > 02_11 End of Life Dementia Care)
  • Benefits and risks of ACP to patients, families and staff – (Advance care planning 01_01 Principles)
  • Cultural and spiritual considerations in ACP – (Advance care planning 01_01 Principles)
  • Approaching ACP when capacity is uncertain, fluctuating, or likely to deteriorate – (Advance care planning 01_02 Process)
  • Discussing ‘Do Not Attempt CPR’ decisions – (Learning paths > 00_01 Priorities for care of the dying person > Priorities for care of the dying person: learning path for doctors > Core sessions)

c) Assessment and Symptom Management

i) Learning objectives

• • Be able to perform a holistic assessment, which induces physical, psychical, social and spiritual needs considering the need to work in a person-centred way which recognises the person as an expert in their own life.
  • Be able to use appropriate tools to assess a range of symptoms or potential symptoms
  • Understand a range of therapeutic opinions for symptoms commonly experience in the last weeks or days of life
  • Be able to describe the key principles of the five priorities for EolC identified by the Leadership Alliance for Care of Dying people (2014) and how this influences practice.
  • Be able to in partnership with others implement, monitor and review a EoLC care plan to address the five priorities for care identified by the Leadership Alliance for Care of Dying people (2014).
  • Demonstrate and awareness of cultural issues that may impact on symptom management
  • Demonstrate an understanding of the rational for or use off : just in case medication, the need to rationalise medication and the indications for a syringe pump to deliver medication
  • Describe sources of support and information that you can access to support you to manage symptoms as required.

ii) e-learning for healthcare modules

• • Carer assessment and support – (Assessment in end-of-life care 02_03 Context)
  • Assessment of dying phase and after-death care – (Assessment in end-of-life care 02_03 Context)
  • Managing distress during the dying phase – (Learning paths > 00_01 Priorities for care of the dying person > Priorities for care of the dying person: learning path for doctors > Additional sessions)
  • Assessment of spiritual wellbeing – (Learning paths > 00_01 Priorities for care of the dying person > Priorities for care of the dying person: learning path for doctors > Additional sessions > Assessment of spiritual wellbeing)
  • Assessing those with fluctuating mental capacity – (Assessment in end-of-life care 02_03 Context)
  • When the dying process is protracted or unexpectedly fast – (Integrating learning in end-of-life care > 05_03 Scenarios)
  • Recognising your own limitations in symptom management – (Symptom management, comfort and wellbeing > 04_01 Principles)
  • Discussing hydration – (Learning paths > 00_01 Priorities for care of the dying person > Priorities for care of the dying person: learning path for doctors > Core sessions)
  • Symptom management in people with learning disabilities – (Symptom management, comfort and wellbeing > 04_08 General issues)
  • Symptom management for the dying adult: pain, and nausea and vomiting (Band 6 RN and above DR Paramedics and Prescribers) – (Learning paths > 00_01 Priorities for care of the dying person > Priorities for care of the dying person: learning path for doctors > Core sessions)
  • Symptom management for the dying adult: respiratory symptoms, diabetes control and anticipatory prescribing (Band 6 RN and above DR Paramedics and Prescribers) – (Learning paths > 00_01 Priorities for care of the dying person > Priorities for care of the dying person: learning path for doctors > Core sessions)
  • Principles of pain management – (Symptom management, comfort and wellbeing > 04_02 Pain)
  • Dying in acute hospitals – (Learning paths > 00_01 Priorities for care of the dying person > Priorities for care of the dying person: learning path for doctors > Core sessions)
  • Using syringe drivers (all participants must have formal competency training prior to using syringe pumps) – (Symptom management, comfort and wellbeing > 04_08 General issues)
  • Drug management of pain: core knowledge – (Symptom management, comfort and wellbeing > 04_02 Pain)
  • Drug management of breathlessness – (Symptom management, comfort and wellbeing > 04_03 Breathlessness)
  • Management of nausea and vomiting – (Symptom management, comfort and wellbeing > 04_07 Last days of life)
  • Treatment and care towards the end of life: good practice in decision-making – (Integrating learning in end-of-life care > 05_05 Best practice)
  • Symptom management complicated by coexisting conditions – (Symptom management, comfort and wellbeing > 04_08 General issues)

d) Bereavement support

i) Learning objectives

• • Describe the purpose of assessment of bereavement needs
  • Discuss what helps people in bereavement
  • Discuss factors that may increase vulnerabilities in bereavement
  • Apply a framework for assessing bereavement
  • Recognise ways of supporting people in bereavement
  • Be aware of and understand the reach and limitations of local support services that can support individuals and their families as an individual approach the end of their lives and into bereavement

ii) e-learning for healthcare modules

• • The Role of the Medical Examiner ( band 6 and above) – (Medical Examiner (MEX) > Core Learning Resource)
  • Bereavement assessment and support – (Assessment in end-of-life care > 02_03 Context)