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End of life care Resources

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The HeART of Empathy: Using the Visual Arts in Medical Education

Primary Author: Florence Gelo, Drexel University College of Medicine

The Heart of Empathy video, and its accompanying Facilitator's Guide, captures Dr. Gelo's technique of using the visual arts to teach medical students and residents how to emotionally prepare for and deal with their patients' suffering and dying.

As medical students and residents view the suffering portrayed in the paintings, the facilitator helps them to articulate and recognize their emotional reactions. Through focused observation and expression of feelings in a non-judgmental humanistic setting, students may cultivate the ability to acknowledge and address the emotional lives of their patients.

Inspired by her experience as a Philadelphia Museum of Art tour guide, Dr. Gelo began to notice the emotional impact of paintings on the viewer, and imagined their use as a powerful teaching resource in medical education. For five years, Dr. Gelo has introduced small groups of Drexel University College of Medicine students and residents to the Philadelphia Museum of Art, where they view and discuss paintings that depict death and dying. This unique experience has been captured in The Heart of Empathy.

The accompanying Facilitator's guide includes program models, resources and suggestions for classroom use.

Date Last Modified 11/01/2008 Video, Faculty Development materials, Manual/guide

The Essential Elements of Spirituality in the End-of-Life Care

Primary Author: Katrina M. Scott, MDiv, BCC, Massachusetts General Hospital

The National Consensus Projects Clinical Practice Guidelines for Quality Palliative Care, published in 2004, defines eight domains of care essential to palliative care clinical practice. The National Quality Forums 2006 document, A National Framework and Preferred Practices for Palliative and Hospice Care Quality: A Consensus Report, which is based on the Guidelines, identifies 38 evidence-based preferred practices for palliative care. This article demonstrates how the Guidelines and Preferred Practices may be operationalized in practice, focusing specifically on Domain 5 of the Guidelines, Spiritual, Religious and Existential Aspects of Care, which incorporates many pertinent aspects of hospice and palliative care related to addressing the spiritual needs of the dying patient and his or her family. In particular, the article addresses methods for assessing the need for spiritual care; methods for communicating with the patient and family about the need for spiritual care; the role of the spiritual adviser on the interdisciplinary palliative care team; the advantages of including certified chaplains on the palliative team; the need for sensitivity toward culture and religious diversity in administering spiritual care; the need for specialized palliative care spiritual advisors to build relationships with community clergy; and more.

Date Last Modified 09/01/2008 Article, Clinical practice guidelines

An Exploratory Study of Spiritual Care at the End of Life

Primary Author: Timothy P. Daaleman, University of North Carolina at Chapel Hill

Article from the Annals of Family Medicine describing a qualitative research study into how spiritual care is perceived and delivered at the end of life. The authors concluded that "Clinicians and other health care workers consider spiritual care at the end of life as a series of highly fluid interpersonal processes ... rather than a set of prescribed and proscribed roles".

Date Last Modified 09/01/2008 Article

Religion, Risk, and Medical Decision Making at the End of Life

Primary Author: Peter H. Van Ness, Yale University School of Medicine and Yale School of Public Health

Article from the Journal of Aging and Health describing a study about whether religious patients are more or less willing to undergo the risks associated with potentially life-sustaining treatment. The authors concluded that "Not all dimensions of religiousness have the same association with willingness to undergo potentially life-sustaining treatment. Seriously ill older, religious patients are not especially predisposed to avoid risk and resist treatment".

Date Last Modified 08/01/2008 Article

Being with Dying: Cultivating Compassion for Self and Others

Primary Author: Joan Halifax Roshi, Upaya Zen Center

This book provides practical and philosophical guidance to caregivers. Roshi Joan Halifax has worked in the area of death and dying for over thirty years, is Director of the Project on Being with Dying, and co-directs The Upaya Buddhist Chaplaincy Training. Each chapter of this book includes a meditation.

Date Last Modified 07/28/2008 Book