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Palliative Care & Hospice Spectrum: Opportunities to Transform Care

presented by Karen Mueller, PhD, DPT, PT, NBC-HWC

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

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As increasing numbers of our population face the challenges of living with severe, chronic and life threatening disease, the effective utilization of healthcare resources is a growing concern. Palliative care and Hospice are well recognized settings in which such care is provided, yet misconceptions abound regarding their appropriate use. These misconceptions prevent timely referrals, compelling patients to seek unnecessary, often painful treatments which limit their quality of life. This course will provide a comprehensive overview of palliative care and hospice, including the indications for admission, the services provided and the outcomes affected. In addition, end of life planning through advanced directives will be discussed. A primary goal of this course is empowering clinicians with the skills to provide appropriate end of life education to families and other healthcare providers, and most of all, to promote patient access to palliative care and hospice programs when indicated. Finally, this course will provide a brief overview of the physical therapist's role in end of life care.

Meet Your Instructor

Karen Mueller, PhD, DPT, PT, NBC-HWC

Karen Mueller, PhD, DPT, PT, NBC-HWC, is a clinical professor and professor emerita in the Department of Physical Therapy and Athletic Training at Northern Arizona University in Flagstaff, AZ. She also holds certifications as a Professional Health and Well-Being Coach (Wellcoaches) and a National Board-Certified Health and Wellness Coach. As a physical therapist for 44…

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Chapters & Learning Objectives

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1. An Overview of Palliative Care

Using a case study of a patient newly diagnosed with ALS, this chapter will explore the concept of palliative care as an extra layer of support to assist with the coordination of care, the promotion of quality of life and the management of symptoms which limit this. This chapter will also explore past and current models of palliative care as well as services provided, payment models and practice settings. Finally, barriers to palliative care access will be explored.

2. An Overview of Hospice Care

The origins of compassionate end of life care began with the vision of Dr. Cicely Saunders, who is known as the founder of the contemporary hospice movement. This chapter will explore the hospice care from several perspectives including the services provided, eligibility requirements and the primary diagnoses served. Finally, eligibility requirements for admission to hospice will be discussed.

3. Advanced Directives and POLST

If you were in a serious accident today, with no hope for recovery, would your family or loved ones know what to do? Surprisinlg, only 30% of Americans can answer positively to this question. Advanced directives may well be the single most important step towards individualized and compassionate end of life care. This chapter will discuss the two components of an advanced directive; the durable medical power of attorney and the living will. Videos of actual end of life discussions will be shown to highlight approaches to end of life planning. Finally, the emerging use of physician orders for life sustaining treatment (POLST) will be discussed, including indications for completion of this document.

4. Physical Therapists and End of Life Care

"My father is dying, why would he need a physical therapist?" This question, commonly asked by patients, and even by other physical therapists, belies the reality of the benefits of physical therapist intervention. This chapter will explore the role of the physical therapist in the provision of non- pharmacologic pain management, patient education and exercise. Briggs’ 2007 model of physical therapist practice patterns will be briefly discussed to provide a contextual framework for the delivery of interventions. A brief overview of end of life outcome measures will be presented and the chapter will end with a patient case study and video.

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