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Kavitha Ramchandran and Jan DeNofrio

This course should be taken after the Symptom Management course and continues building your primary palliative care skills – communication, psychosocial support, goals of care, and symptom management. You will explore transitions in care such as survivorship and hospice. You will learn how to create a survivorship care plan and how to best support a patient. The course also covers spiritual care and will teach you how to screen for spiritual distress. Finally, you will learn the requirements for hospice care and practice discussions difficult conversations related to end-of-life care.

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This course should be taken after the Symptom Management course and continues building your primary palliative care skills – communication, psychosocial support, goals of care, and symptom management. You will explore transitions in care such as survivorship and hospice. You will learn how to create a survivorship care plan and how to best support a patient. The course also covers spiritual care and will teach you how to screen for spiritual distress. Finally, you will learn the requirements for hospice care and practice discussions difficult conversations related to end-of-life care.

Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Visit the FAQs below for important information regarding 1) Date of original release and Termination or expiration date; 2) Accreditation and Credit Designation statements; 3) Disclosure of financial relationships for every person in control of activity content.

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What's inside

Syllabus

Course Introduction and Overview
Welcome to Transitions in Care from Survivorship to Hospice, the third course in the Palliative Care Always specialization. This course focuses on the major changes that occur during the care continuum and how these changes impact the patient. This module will provide you with information on the course structure and first steps.
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Review of Palliative Care
This module reviews the concepts learned in the Essentials of Palliative Care course and a brief summary of the symptoms covered in the Symptom Management in Palliative Care course. We realize that some learners are interested in only completing specific courses while others are moving through the entire specialization. Therefore the following videos are meant as a review for those who have not completed the other courses. You are not required to watch these videos if you feel you have a strong handle on the material. You can check your knowledge with the ungraded quiz in the next section and review the summary videos if necessary. Also contained in this module are the Sarah case study videos from Essentials of Palliative Care for those who want to review her story. Check your knowledge with the ungraded quiz in the next section and review the summary videos, if necessary. Also contained in this module are the Sarah case study videos from Essentials of Palliative Care and Symptom Management in Palliative Care for those who want to review her story.
Survivorship
Survivorship can be different depending on the type of serious illness the patient experiences. Patients define survivorship in a variety of ways – some define themselves as survivors when in remission, while other define survivorship as living each day fully while battling disease.Survivorship is most commonly discussed in the cancer setting as patients can be considered survivors during remission. In this module we will discuss survivorship in an oncology setting and a chronic disease setting such as liver disease.
Spiritual Care
Families experiencing a serious illness deal with pervasive physical, emotional, and spiritual distress. Spiritual concerns and emotional concerns are very much intertwined. Studies show that patients rely on spirituality to cope and find strength; positive religious coping is associated with improved comfort, increased self-esteem, and decreased anxiety. When people experience spiritual distress, the loss of this coping mechanism can compound negative effects of illness and increase suffering. Increasingly, spiritual care professionals such as chaplains work as part of healthcare teams to support the spiritual needs of families. Still, all members of the care team can gain the skills to identify and respond to spiritual distress. This module explores spirituality, spiritual distress, and how to leverage hope and forgiveness to bring comfort to patients and families.
Hospice Care
Now we will take a look at death as a part of life. Palliative care, as we have learned throughout this course, is rooted in supporting optimal quality of life throughout the care continuum. While end-of-life is but one phase of this experience, hospice care is an invaluable tool to help patients and families live and die with dignity and comfort. During this module, you will learn more about identifying when a transition to hospice is warranted and tips for discussing the transition to hospice care. You will learn more about how the hospice team supports patients and families at end-of-life and experience a hospice home visit with Dr. Ellen Brown.
Final Steps
Congratulations on completing the course content. You have a few more step to complete the course. First review your reflection, next complete a peer-reviewed course project and then take the final exam. We hope you have enjoyed the course and look forward to seeing you in other classes!

Good to know

Know what's good
, what to watch for
, and possible dealbreakers
Develops knowledge of survivorship care plans, which are important for patient wellness and next steps after a serious illness or cancer diagnosis
Examines how spirituality impacts well-being and introduces techniques to support spiritual care in healthcare settings, where such concerns are often overlooked
Provides guidance on when and how to initiate discussions about hospice care, a critical but often neglected aspect of palliative care
Taught by Kavitha Ramchandran and Jan DeNofrio, who are recognized educators and practitioners in palliative care
Offers a comprehensive understanding of the transitions in care that occur throughout the illness trajectory, providing a holistic approach to patient support
Requires prerequisite knowledge in palliative care principles, potentially limiting accessibility for learners without a foundation in this field

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Reviews summary

Patient-focused hospice care

Learners say this hospice care course overly focuses on patient-provider communication and does not provide enough practical tips on managing patients' suffering. As a result, students feel disappointed with the course content and do not recommend it to others.
Focuses too much on communication skills.
"It is important, but only one part of palliative care."
"I wish it was more oriented to practical tips and guidelines to alleviate suffering in patients."
Lack of practical content.
"I wish it was more oriented to practical tips and guidelines to alleviate suffering in patients (e.g., medication, physical therapy, care of patients with dyspnea, management of pain), but the whole course was mostly focused on patient-provider communication."
"I did not learn anything new, to be honest."

Activities

Be better prepared before your course. Deepen your understanding during and after it. Supplement your coursework and achieve mastery of the topics covered in Transitions in Care from Survivorship to Hospice with these activities:
Join a study group or connect with other students
Enhance your learning through collaborative discussions and knowledge sharing.
Show steps
  • Find a study partner or group.
  • Schedule regular meetings.
  • Discuss course material, share insights, and support each other.
Test your knowledge through practice quizzes
Test your understanding of the concepts covered in each module with frequent practice quizzes.
Show steps
  • Access the practice quizzes available online.
  • Attempt the quizzes regularly.
  • Review your answers and learn from your mistakes.
Offer support to fellow learners
Deepen your understanding by explaining concepts to others and providing assistance.
Show steps
  • Join online discussion forums.
  • Answer questions and share your insights.
  • Offer support and encouragement.
Three other activities
Expand to see all activities and additional details
Show all six activities
Explore online resources for further learning
Expand your knowledge and skills by accessing additional resources that complement the course material.
Show steps
  • Search for online tutorials and articles.
  • Follow step-by-step instructions.
  • Apply what you learn to your assignments.
Develop a self-care plan
Enhance your ability to manage your own health and well-being by creating a personalized self-care plan.
Show steps
  • Identify your physical, emotional, and spiritual needs.
  • Research and incorporate evidence-based practices.
  • Create a written plan that outlines your strategies.
Share your understanding through blog posts or articles
Solidify your learning by creating written content that explains course concepts to others.
Show steps
  • Choose a topic related to the course material.
  • Research and gather information.
  • Write a well-structured blog post or article.

Career center

Learners who complete Transitions in Care from Survivorship to Hospice will develop knowledge and skills that may be useful to these careers:
Hospice and Palliative Care Nurse
In your role as a Hospice and Palliative Care Nurse, you will play a vital part in supporting patients and their families during challenging end-of-life transitions. The Transitions in Care from Survivorship to Hospice course will give you the skills and knowledge you need to provide compassionate care to patients, supporting them through various stages of illness and helping them achieve a peaceful and dignified end of life.
Hospice Social Worker
Hospice Social Workers provide emotional and practical support to patients and their families during end-of-life care. The Transitions in Care from Survivorship to Hospice course will help you develop the skills needed to assess the psychosocial needs of patients and families, provide counseling and support, and connect them with community resources.
Spiritual Care Provider
Spiritual Care Providers offer spiritual support and guidance to individuals facing serious illness and end-of-life issues. This course will equip you with the understanding of spirituality, spiritual distress, and the tools to effectively address spiritual concerns, providing comfort and support to patients and their loved ones during challenging times.
Palliative Care Physician
Palliative Care Physicians specialize in providing comprehensive care to patients with serious illnesses, focusing on improving their quality of life and relieving suffering. The Transitions in Care from Survivorship to Hospice course will complement your medical knowledge by equipping you with the skills to manage symptoms, communicate effectively with patients and families, and support decision-making regarding end-of-life care.
Grief Counselor
Grief Counselors provide support and guidance to individuals who are grieving the loss of a loved one. The Transitions in Care from Survivorship to Hospice course will enhance your understanding of the grieving process and provide you with practical tools to help clients cope with their emotions and adjust to life after loss.
Bereavement Coordinator
Bereavement Coordinators support families who have lost a loved one, providing practical and emotional assistance during their time of grief. The Transitions in Care from Survivorship to Hospice course will equip you with the skills to create and implement bereavement programs, facilitate support groups, and provide resources to grieving families.
Patient Advocate
Patient Advocates represent and support patients' rights and interests throughout their healthcare journey. The Transitions in Care from Survivorship to Hospice course will enhance your understanding of healthcare systems and provide you with the skills to effectively navigate end-of-life care decisions and support patients' choices.
Chaplain
Chaplains provide spiritual care and support to individuals in various settings, including hospitals and hospice centers. The Transitions in Care from Survivorship to Hospice course will deepen your understanding of spirituality and equip you with the skills to provide compassionate care to patients and their families, addressing their spiritual needs and offering comfort during challenging times.
Music Therapist
Music Therapists use music to support the physical, emotional, and cognitive well-being of individuals. The Transitions in Care from Survivorship to Hospice course will provide you with insights into the role of music in end-of-life care and equip you with the skills to use music to provide comfort, reduce stress, and facilitate self-expression for patients and their loved ones.
Art Therapist
Art Therapists use art to help individuals explore their emotions, improve communication, and cope with challenges. The Transitions in Care from Survivorship to Hospice course will provide you with a foundation in art therapy and its applications in end-of-life care, enabling you to use art to facilitate healing, self-expression, and connection for patients and their families.
Massage Therapist
Massage Therapists use touch and massage techniques to promote relaxation, reduce stress, and relieve pain. The Transitions in Care from Survivorship to Hospice course will equip you with the skills to provide massage therapy in end-of-life care settings, offering comfort, reducing anxiety, and promoting relaxation for patients and their loved ones.
Acupuncturist
Acupuncturists use acupuncture to promote physical and emotional well-being by stimulating specific points on the body. While not a substitute for medical care, acupuncture may be helpful in managing symptoms and improving quality of life for patients receiving end-of-life care. This course may provide you with a foundation in acupuncture and its potential applications in this field.
Yoga Instructor
Yoga Instructors guide individuals through yoga poses and breathing exercises to promote physical, mental, and emotional well-being. The Transitions in Care from Survivorship to Hospice course may provide you with some insights into the benefits of yoga in end-of-life care, such as reducing stress, improving sleep, and promoting relaxation for patients and their loved ones.
Meditation Teacher
Meditation Teachers guide individuals through meditation practices to promote mindfulness, reduce stress, and cultivate inner peace. The Transitions in Care from Survivorship to Hospice course may offer some insights into the benefits of meditation in end-of-life care, such as reducing anxiety, improving mood, and promoting a sense of well-being for patients and their loved ones.
Tai Chi Instructor
Tai Chi Instructors guide individuals through gentle movements and exercises to promote balance, coordination, and overall well-being. The Transitions in Care from Survivorship to Hospice course may provide some insights into the benefits of Tai Chi in end-of-life care, such as improving mobility, reducing pain, and promoting relaxation for patients and their loved ones.

Reading list

We've selected eight books that we think will supplement your learning. Use these to develop background knowledge, enrich your coursework, and gain a deeper understanding of the topics covered in Transitions in Care from Survivorship to Hospice.
A practical guide to palliative care nursing, covering topics such as pain management, symptom management, and spiritual care. is written for nurses working in a variety of settings, including hospitals, hospice, and home care.
The Oxford Textbook of Palliative Medicine stands alone as the most comprehensive and scientifically rigorous textbook on the subject, providing an in-depth analysis of the current state of palliative medicine. However, it may be beyond the reading level of audiences who are new to Palliative Care.
A comprehensive guide to cancer survivorship, covering topics such as physical, psychological, and social issues. is written for healthcare professionals who work with cancer survivors.
Is written to a lay audience, and may be useful for learners who wish to explore more about death and dying from a more personal perspective.
A memoir by a young neurosurgeon who was diagnosed with cancer. provides a unique perspective on the experience of dying and the importance of living each day to the fullest.
A book about the spiritual aspects of dying. explores the five invitations that death offers us: to be present, to be authentic, to be compassionate, to forgive, and to let go.
A memoir about the author's visits with his former college professor, who is dying of ALS. provides a moving and insightful look at the experience of dying and the importance of relationships.

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