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Managing Difficult Conversations at the End of Life

presented by Cathleen Armato, RN, CHC, CHPC

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Disclosure Statement:

Financial: Cathleen Armato is a share holder with Armato & Associates, LLC. Cathleen Armato receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.
Non-Financial: Cathleen Armato has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Video Runtime: 47 Minutes


Some important conversations are just hard, and many clinicians do not feel prepared to cover tough topics such as death and dying, suicide, fears, grief, and many others. Addressing patients' and families' thoughts and concerns about the consequences of a life-limiting illness requires a specific skill-set. This course provides information and tools to help the clinician gain comfort with these difficult conversations. Whether engaging in or facilitating these conversations, end-of-life clinicians have an important role. Case studies will be reviewed, and patient and family perspectives will be examined. Additionally, the role of bias and assumptions will be explored. Finally, this course will review professional growth through experience, reflection, and analysis of hard conversations.

Meet Your Instructor

Cathleen Armato, RN, CHC, CHPC

Cat Armato is an experienced executive with 18 years in the home care and hospice industry. She has served in various roles during that time, including VP of operations and chief compliance officer for a nationwide provider. In 2012, Cat became a consultant. She has assisted multiple organizations with their compliance and quality efforts, from…

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Chapters & Learning Objectives

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1. Preparing for Difficult Conversations

Some conversations are just going to be difficult, but each difficult conversation increases the clinician's experience and preparedness for the next one. This chapter reviews barriers and facilitators to effective communication as well as ways to minimize our own personal bias and assumptions when engaging in these conversations. Finally, this chapter will look at how to balance empathy with professional boundaries to avoid compassion fatigue.

2. Patient and Family Perspectives About Communicating

Patients and families want to be heard, but clinicians want to have answers. This chapter will help the clinician bridge this gap in goals of communication. Patient-centered communication will be examined so power and responsibility can effectively be shared. This chapter also discusses facilitating difficult conversations between the terminally ill and their family members.

3. Four Case Studies in Difficult Conversations

This chapter will present four actual cases for review. Topics in this course will include pain management, refusal of care, pediatric issues, family disagreements, and suicidal ideations. Each case will examine the conversations that occurred and the outcomes of those conversations.

4. Reflecting After a Difficult Conversation

In any difficult conversation, there are things that went well and things that could have been handled better. This chapter looks at professional growth through meaningful reflection and after-action reviews. There is an opportunity to learn from each experience and be even better prepared for the next time.

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