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Palliative Care Objectives and References

Objectives:

By the end of Family Medicine Clerkship, students will be able to:
1. Explain the definition of the following terms and their application in palliative care settings and/or advanced care planning:
a. code status
b. personal care directives
c. substitute decision-makers
d. power of attorney.
2. Propose a management plan for patients receiving palliative care with
a. pain
b. nausea
c. constipation
d. dyspnea
3. Identify local resources to support palliative patients & their families.
4. Recognize and seek assistance for the following palliative emergencies: opioid neurotoxicity, spinal cord compression, seizures, acute hemorrhage, and acute confusion/delirium.

References:

Recommended Resources Addressing the Objectives
Just ask: discussing goals of care with patients in hospital with serious illness. (7 pages)
Objectives covered: 1abc, 3
You JJ, Fowler RA, Heyland DK, Canadian Researchers at the End of Life Network (CARENET). Just ask: discussing goals of care with patients in hospital            with serious illness. CMAJ 2014 Apr 1;186(6):425-432.
PMID:23857860
Advance directives in the context of end-of-life palliative care (5 pages)
Objectives covered: 1bcd
Perez Mdel V, Macchi MJ, Agranatti AF. Advance directives in the context of end-of-life palliative care. Curr Opin Support Palliat Care 2013 Dec;7(4):406-           410.
PMID:24152977
Pharmacologic Pearls for End-of-Life Care (6 pages)
Objectives covered: 2abcd, 4ae
Clary PL, Lawson P. Pharmacologic pearls for end-of-life care. Am Fam Physician 2009 Jun 15;79(12):1059-1065.
PMID:11578023
Management of emergent conditions in palliative care (10 pages)
Objectives covered: 4bcd
Wrede-Seaman LD. Management of emergent conditions in palliative care. Prim Care 2001 Jun;28(2):317-328.
PMID:11406437
Foundational knowledge
The Calgary Guide - Explaining why the side effects of opiod medications arise -
Additional resources
Emil: Palliative Care online virtual patient case
Objectives covered: 1bcd, 2, 3, 4

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