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End of Life Care Summer Fellowship AMSA Project Proposal Chicago, IL Summer 2003

End of Life Care Summer Fellowship AMSA Project Proposal Chicago, IL Summer 2003. Heather R. Goffinet Chicago College of Osteopathic Medicine Midwestern University Mentors: Corrine Nawrocki, D.O. Karen Nichols, D.O. Proposal Goals/Ideas for implementation of EOL information into curriculum.

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End of Life Care Summer Fellowship AMSA Project Proposal Chicago, IL Summer 2003

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  1. End of Life Care Summer FellowshipAMSA Project ProposalChicago, IL Summer 2003 Heather R. Goffinet Chicago College of Osteopathic Medicine Midwestern University Mentors: Corrine Nawrocki, D.O. Karen Nichols, D.O.

  2. Proposal Goals/Ideas for implementation of EOL information into curriculum • Prepare/present lecture for MS1 in Introduction to Clinical Medicine • Initiate AMSA “Death and Dying” Special Interest Group • Act as student liaison between administration and student body in aspects of EOL topics in curriculum; bridge the gap between M1-2/3-4

  3. ICM Lecture Topics: Introduction • Picture your own death: Students will be asked to prepare a brief paragraph of their death • Where will you be? • Who will be in the room? • What objects will be in the room? • What will the ambiance of the room be? • Describe “the room.”

  4. ICM Lecture Topics: What to expect • Final stages of Death • What to expect in terms of physiological changes, neurological dysfunction, signs of imminent death, signs that death has occurred • How to discuss patient status as death approaches: • What is useful to say to family? • What not to say • How to communicate effectively so family will be better prepared for what to expect • What to do when death has occurred • Show segment of Bill Moyers film on family discussion of what to expect at time of death

  5. ICM Lecture Topics: Legalities • Explain Power of Attorney • Explain Living Will • Explain Advanced Directives • How to initiate discussion • “I would like to take a few minutes for us to discuss an important topic– I would like to know how I should care for you if you were to become very ill.” • Explain DNR • Explain Illinois health care “surrogate” • Students will be given ISMS Personal Decision guide to fill out

  6. ICM Lecture Topics: Hospice • Describe overall philosophy of Hospice care • Why is it important for medical students/physicians to understand Hospice? • What “is” Hospice/What Hospice “is not” • Hospice is not allowing a patient to die more quickly • Hospice is not about giving up • Hospice is a resource during the dying process • Expertise management in physical, emotional, spiritual pain • Describe the roles of the Hospice team

  7. ICM Lecture Topics: Hospice and Osteopathy • Illustrate overlapping philosophies of Osteopathy and Hospice • Ultimate goal to treat the patient as a whole being: relationship of structure, function, and overall interaction of all body systems • Focus on patient as a whole, NOT the disease • Includes focusing on socioeconomic factors, cultural awareness, spiritual awareness, etc.

  8. ICM Lecture Topics: PBL • Case discussion to include the following: • Disease diagnosis and progression • Pain management information • Family interactions • How to speak with patient about imminent death

  9. ICM Lecture Topics: Overall Goal • Explain the number one concrete fact in medicine…Everyone dies! We should not hasten death, but provide a comfortable passage into the next realm, whatever that may be • Explain palliative medicine: Palliate, Latin origin “to cloak”, “to protect” • As a physician, it is best to know when to treat curatively and when to treat palliatively

  10. Goals for Death and Dying Special Interest Group: Getting Started • Various lunch discussions: • “Holding Hands with the Dying: A Medical Student’s Perspective” Special thanks to Hamayun Nawaz for allowing use of his fantastic photography • Pain Management at EOL- ? Physician or RN guest speaker • Spiritual Concerns with the dying and their families- ? Guest speaker such as Chaplain, Social worker

  11. Goals for Death and Dying Special Interest Group: Continued • Video and Discussion • “To Live Until I Die” video to introduce Hospice, followed by workshop • Workshops • How do I give a terminal diagnosis? • How do I speak to patient and family about the dying process? • What factors do I need to consider for my patient at the EOL?

  12. Holding Hands with the Dying: A Medical Student’s Perspective

  13. Goals for Death and Dying Special Interest Group: Continued • “Wit” movie night • Questions to consider: • How did you feel about the physicians style of diagnosis? • As her ca progresses, how do you feel about the medical team’s approach? • What are your thoughts about Jason? What about the “research subject” statement at her time of death? • Did she die a “good death?” What is a “good death?” • What are your thoughts about the professor visiting?

  14. A special thanks to my fellow classmates, Lori, Rachel, Dr. Marschke, Dr. Preodor, Horizon Hospice team, Hospice of Illinois team, and Vitas team for allowing one of the most important experiences in my career as a future physician. This summer experience has been an invaluable resource. It is with great honor that I will attempt to see these goals to completion at CCOM. 

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