Resources

End of Life Resources

Welcome to the End-of-Life Resources page; a library of information meant to assist physicians, caregivers, and patients find the information they need to better carry out end-of-life care.  Can't find what you're looking for?  Check back in soon becuse we are adding resources daily to continue populating the end-of-life resource categories. 

You may use the categories below to browse topics and resources or use the "Search EOLR" function on the left sidebar. 

End of Life Resources
# 012 Myths About Advance Directives, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Written advance directives are legal in every stat; laws and forms, however, vary state to state. See Fast...
FAMILY CARERS IN PALLIATIVE CARE: A Guide for Health and Social Care Professionals Oxford University Press
Review:  Providing care and support for the family of the patient is one of the basic, almost sacred, tenets of...
PAIN MANAGEMENT: Enhancing Your Life to the Fullest Anshan
Review:  Here is a book for patients with pain and for parents with children who have pain, written by someone who has...
PALLIATIVE CARE FOR CARE HOMES: A Practical Handbook Radcliffe Publishing
Review:  As the populations in our societies age, there will be more and more individuals in care homes who have life-...
Palliative Care — A Shifting Paradigm The New England Journal of Medicine
This editorial by Diane Meier, M.D. and Amy Kelley, M.D., M.S.H.S. gives a very in-depth definition of palliative care, how...
THE LAST GIFTS: Creative Ways to be with the Dying Andrews McMeel Publishing
Review:  This is a remarkable book written by an insightful occupational therapist who works in palliative care in New...
When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families Institute of Medicine of the National Academies
 "We are in need of medicine with a heart. . . . The endless physical, emotional, and financial burdens that a...
"Do not punctuate the end of your life with a senseless act of brutality!"
Words have power. Language has power. The words we use may comfort or shock, allay or provoke, sooth or batter. Words ...
"Fighting On" Deciding how and when to continue care at the end of life New England Journal of Medicine
Fighting on gives a real-life account of the challenges that come with end of life care.  Should care be prolonged?...
"I Grieve" - Peter Gabriel
  The grieving process is incredibly important for anyone trying to cope with and understand loss.  This song, by...
"Living Old" - Frontline's 2006 documentary on aging
"A powerful and intimate journey into the uncharted territory of Americans living longer than ever -- and what it means...
"Vesta” Performed Across Country
This Bryan Harnetiaux play offers a warm and often funny exploration of a family’s struggle with a variety of end-of-...
# 001: Diagnosis and Treatment of Terminal Delirium, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Some degree of loss of cognitive function occurs in most patients in the week or two before death. The...
# 002 Converting to/from Transdermal Fentanyl, 2nd ed Medical College of Wisconsin (EPERC)
Background:  what dose of the transdermal fentanyl patch (DuragesicTM) is equianalgesic to a 3 mg/hr morphine...
# 003 Syndrome of Imminent Death, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Virtually all dying patients go through a stereotypical pattern of symptoms and signs in the days prior to...
# 004 Death Pronouncement in the Hospital, 2nd ed Medical College of Wisconsin (EPERC)
Background:   Physicians traditionally have little formal training in examining patients to determine death, notifying...
# 005 The Causes of Nausea and Vomiting (V.O.M.I.T.), 2nd ed Medical College of Wisconsin (EPERC)
Background:  By understanding the pathophysiology of nausea and targeting antiemetics to specific receptors, therapy...
# 006 Delivering Bad News-Part 1, 2nd ed Medical College of Wisconsin (EPERC)
Case Scenario:  You are caring for a previously healthy 52 year old man with a new problem of abdominal pain. After...
# 007 Depression in Advanced Cancer, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Diagnosing and providing treatment for a major depressive episode in patients with advanced cancer can...
# 008 Morphine and Hastened Death, 2nd ed Medical College of Wisconsin (EPERC)
Question:  What is the distinction between the use of morphine at the end of life to control symptoms and euthanasia/...
# 010 Tube Feed or Not Tube Feed?, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Tube feeding is frequently used in chronically ill and dying patients. The evidence for much of this use...
# 011 Delivering Bad News-Part 2, 2nd ed Medical College of Wisconsin (EPERC)
  Case Scenario:  You are caring for a previously healthy 52 year old man with a one-month of abdominal pain and...
# 013 Determining Prognosis in Advanced Cancer, 2nd ed Medical College of Wisconsin (EPERC)
Background:  How long do I have, Doc? is among the most common questions asked by cancer patients, especially when...
# 014 Palliative Chemotherapy, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:  One often hears the term palliative chemotherapy, but what exactly does it mean and how can a non-...
# 015 Constipation, 2nd ed Medical College of Wisconsin (EPERC)
Constipation:  it's not fun to have or to treat. As with other symptoms, rational therapy should be based on a sound...
# 016 Moderating an End-of-Life Family Conference, 2nd ed Medical College of Wisconsin (EPERC)
Background:   At some point during the course of a terminal illness, a meeting between health care professionals and...
# 017 Patient-Centered Interviewing, 2nd ed Medical College of Wisconsin (EPERC)
Clinical Case:  You admit Mary, a new patient, to the hospital. Mary has end-stage, metastatic pancreatic cancer. She...
# 018 Short-Acting Oral Opioid Dosing Intervals, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Oral opioids are among the most commonly prescribed drugs in palliative care. Despite national analgesic...
# 019 Taking A Spiritual History, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Illness raises fundamental questions – For what may I hope? Why do I suffer? Does my suffering have...
# 020 Opioid Dose Escalation, 2nd ed Medical College of Wisconsin (EPERC)
Background:   A common question from trainees is how fast, and by how much, can opioids be safely dose escalated? I...
# 021 Hope and Truth Telling, 2nd ed Medical College of Wisconsin (EPERC)
This Fast Fact discusses the difficult balance between maintaining hope and truth telling, especially as it applies to...
# 022 Writing a Condolence Letter, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:  One of the most meaningful acts of kindness you can do for a mourner is to write a letter of condolence...
# 023 Discussing DNR Orders-Part 1, 2nd ed Medical College of Wisconsin (EPERC)
Background:  ‘Code status’ discussions with seriously ill patients should always take place in the context...
# 024 Discussing DNR Orders-Part 2, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:  The basic steps in the DNR discussion for seriously ill hospitalized patients were described In Fast...
# 025 Opioids and Nausea, 2nd ed Medical College of Wisconsin (EPERC)
Background:   Why do patients get nauseated and vomit after receiving an opioid? Commonly described as an “...
# 026 The Explanatory Model, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:  Have you ever had this experience – you are talking with a patient about some care option and you...
# 027 Dyspnea at End of Life, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:  Dyspnea is defined as a subjective sensation of difficulty breathing. This Fast Fact reviews key...
# 028 Subcutaneous Opioid Infusions, 2nd ed Medical College of Wisconsin (EPERC)
Background:  A parenteral opioid infusion is the standard of care for managing moderate-severe pain or dyspnea when the...
# 029 Responding to Patient Emotion, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:  Listening to, recognizing, and responding to patient emotions is an essential skill for physicians who...
# 030 Prognostication, 2nd ed Medical College of Wisconsin (EPERC)
Intro:  Physicians tend to be overly optimistic when dealing with prognosis. A study by Christakis illustrates this...
# 031 Confronting Personal Mortality, 2nd ed Medical College of Wisconsin (EPERC)
Intro:  Most of us fear our own death; it is part of the human experience. Various authors suggest that the desire to...
# 032 Grief and Bereavement, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:  Grief is a normal response to loss, any loss: a job, a limb, a life. Clinicians have an important role...
# 033 Ventilator Withdrawal Protocol, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:  This is the first part of a three-part series on withdrawing ventilators in patients expected to die....
# 045 Medical Management of Bowel Obstruction, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Malignant bowel obstruction is a common oncologic complication; most common in ovarian and colon cancer...
# 066 Radiation for Palliation - Part 1, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Radiation therapy (XRT) is used with palliative intent to improve quality of life by improving function...
# 067 Radiation for Palliation - Part 2, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Fast Fact #66 discussed the physiology and methods of delivering radiation therapy (XRT). This Fast...
# 076 Telephone Notification of Death - Part 1, 2nd ed Medical College of Wisconsin (EPERC)
Background:  Telephone notification to family members about a death is one of the most challenging and stressful...
# 077 Telephone Notification of Death - Part 2, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:  In Part I (Fast Fact # 76), the basic steps and precautions of telephone notication of death were...
# 082 Medicare Hospice Benefit: Part 1 Eligibility and Treatment Plan, 2nd ed Medical College of Wisconsin (EPERC)
Background:   In the United States, the Medicare Hospice Benefit (MHB) pays for 80% of all hospice care. Established in...
# 084 Swallow Studies, Tube Feeding and the Death Spiral, 2nd ed Medical College of Wisconsin (EPERC)
Introduction:   The reflex by families and doctors to provide nutrition for the patient who cannot swallow is...
# 096 Diarrhea in Palliative Care, 2nd ed Medical College of Wisconsin (EPERC)
"Fast Facts and Concepts provide concise, practical, peer-reviewed, and evidence-based summaries on key topics...
# 101 Insomnia: Patient Assessment Medical College of Wisconsin (EPERC)
Background:   Sleep disorders are very common in the general population, the elderly, and in terminally ill patients....
# 105 Insomnia: Pharmacological Therapies Medical College of Wisconsin (EPERC)
Introduction:   Fast Facts #101 and #104 reviewed assessment of insomnia and its non-pharmacological therapy. This Fast...
# 128 The Speech Pathologist and Swallowing Studies Medical College of Wisconsin (EPERC)
Background:   Speech pathologists can facilitate communication among members of the medical team, and between the team...
# 215 Opioid Poorly Responsive Cancer Pain Medical College of Wisconsin (EPERC)
Background:   Relief of cancer pain from opioids is rarely all or nothing; most patients experience some degree of...
# 216 Asking about Cultural Beliefs in Palliative Care Medical College of Wisconsin (EPERC)
Background:   Patients’ cultural backgrounds profoundly influence their preferences and needs regarding...
# 232 Family Presence During Resuscitation Medical College of Wisconsin (EPERC)
Background:  Cardiopulmonary resuscitations are abrupt and traumatic clinical events that frequently result in a...
#221 Treatment of Pain in Patients Taking Buprenorphine for Opioid Addiction Medical College of Wisconsin (EPERC)
Background:  This Fast Fact discusses treating pain in patients using buprenorphine for opioid addiction. ...
#230 Using Non-Invasive Ventilation at the End of Life. Medical College of Wisconsin
Background:  Non-invasive positive pressure ventilation (NPPV, often called ‘BiPAP’) is commonly used in...
2011 Cunniff-Dixon Hastings Center Physician Awards Video
Care for patients at the end of life has long troubled American medicine, not only in its failure to provide good palliative...
A communication approach for oncologists: understanding patient coping, communicating about bad news, palliative care and hospice Journal of the National Comprehensive Cancer Network : JNCCN
This abstract from the Journal of the National Comprehensive Cancer Network talks about the importance of communication...
A Doctor's Blog: Improving Palliative Care in the ED Pallimed Hospice and Palliative Care Blog
This recent blog posting by Dr. Rosielle begins an interesting dialogue on palliative care in the emergency room.  His...
A guide to wound managment in palliative care. International Journal of Palliative Nursing
 Abstract:  Wound management in palliative patients is often a very challenging area of care. There are many...
A Meeting Poem from "A Part"
In a dream I meet my dead friend. He has, I know, gone long and far...   Link to Full Poem
A Palliative Prognostic Score for Terminally Ill Children and Adolescents With Cancer (PDF Attached) Pediatric Blood and Cancer
Background: The loss of a child is considered the hardest moment in a parent’s life. Studies addressing length of...
A Pilot Study Evaluating the Safety and Efficacy of Modafinal for Cancer-Related Fatigue Journal of Palliative Medicine
Abstract:  Fatigue is a common symptom that lowers the quality of life of patients with cancer, affecting between 60%...
A Practical Approach to the Family That Expects a Miracle American College of CHEST Physicians
Abstract:  When a patient is extremely ill and/or dying, and the family expects a miraculous recovery, this situation...
A Surgeon's Blog: The Microcosm
The following is a blog posting from Jeffry Parks MD, a general surgeon from Cleveland, OH.  It's a case about an...
A systematic review of the effectiveness of Chinese herbal medication in symptom management and improvement of quality of life in adult cancer patients. Complementary Therapies in Medicine
Abstract:  The aim of this systematic review was to assess the effectiveness of Chinese medicinal herbs used...
AARP Caregiving Page
AARP’s mission is to enhance the quality of life for all as they age, leading positive social change and delivering...
About.com Pallliative Care Blog: Moments with Baxter: the Hospice Angel
The most recent (November 18) blog entry from Angela Morrow, RN about a hospice dog, Baxter, who brought cheer to dozens of...
Academy for Guided Imagery
The Academy for Guided Imagery (AGI) is dedicated to educating and supporting practicing health care clinicians, coaches,...
Acupuncture for Pediatric Pain and Symptom Management Pediatric Clinics of North America
This article provides a clear and concise overview of acupuncture including definitions, research studies, history, concepts...
Acupuncture in palliative care Supportive Care in Cancer
Abstract:  Acupuncture involves the insertion of needles into designated acupuncture points to aid in the treatment of...
Administration on Aging: National Family Caregiver Support Program
The Administration on Aging has an informative segment of their website on The National Family Caregiver Support Program...
Adolescents with life-threatening illnesses The American Journal of Hospice and Palliative Care
Abstract:  Adolescents have unique physical and psychosocial needs. Adolescents want to gain autonomy, yet they must...
Adult Congenital Heart Association
Seeks to improve the qualtiy of life and extend the lives of adults with congenital heart defects. Education, outreach,...
Advance Care Planning: Role of the Primary Care Physician
American Academy of Hospice and Palliative Medicine
The American Academy of Hospice and Palliative Medicine (AAHPM) is dedicated to expanding access of patients and families to...
American Academy of Pain Medicine
The American Academy of Pain Medicine (AAPM) is the medical specialty society representing physicians practicing in the...
American Association of Kidney Patients (AAKP)
  “The American Association of Kidney Patients (AAKP) is a national, nonprofit organization founded by kidney...
American Heart Association
  The American Heart Association is committed to reducing disability and death from the nation's number one and number...
American Pain Foundation
The American Pain Foundation (APF) offers a website that features published resources, links, online support and a monthly...
American Pain Society
The American Pain Society is a multidisciplinary community that brings together a diverse group of scientists, clinicians...
American Pain Society: Pediatric Chronic Pain
The link below connects to a position statement from the American Pain Society on Pediatric Chronic Pain.  It speaks on...
An evaluation of two decision-making scales for children with life-limiting illnesses. Palliative Medicine
Abstract:  Annually, about 500,000 children are coping with life-limiting illnesses. Many of these children could...
An unusual cause of insomnia. Palliative Medicine
Abstract:  We report the case of a patient with tonsillar carcinoma, presenting with insomnia and symptoms of...
Anna Deavere Smith: "Let Me Down Easy"
The link below is to a November 6, 2009 episode of democracy now where Amy Goodman interviews Anna Deavere Smith who...
Are We Training Our Fellows Adequately in Delivering Bad News to Patients? A Survey of Hematology/Oncology Program Directors. Journal of Palliative Medicine
Abstract:  Medical oncologists often must deliver bad news. The authors were interested in the extent of formal...
Artificial Nutrition and Hydration: Clinical Issues Journal of Hospice and Palliative Nursing
Abstract:  Artificial nutrition and hydration (ANH) are common but controversial therapies at the end of life. Although...
Assessment of Patients' Competence to Consent to Treatment New England Journal of Medicine
This article from the New England Journal of Medicine presents a case study on the challenging scenario of assessing...
Assigning an appropriate surrogate. The American Journal of Hospice and Palliative Care
This article from The American Journal of Hospice and Palliative Care is a case study about a 22 year old man who sustained...
Audio Podcast: End-of-Life Care For Children: Adding Life to a Child's Time
This is an audio podcast from Hospice Palliative Care Insights, a monthly palliative care podcast based in Canada.  In...
Audio Podcast: Patients Choose Complementary and Alternative Medicine
This is an audio podcast from Hospice Palliative Care Insights, a monthly palliative care podcast based in Canada.  In...
Audio Podcast: Spiritual and Religious Care of the Hospice Palliative Care Client.
This is an audio podcast from Hospice Palliative Care Insights, a monthly palliative care podcast based in Canada.  In...
Bastyr Center for Natural Health: Chinese Herbal Dispensary
Bastyr is one of North America's best naturopathic medical schools.  Associated with the school is their center for...
Benson-Henry Institute for Mind Body Medicine at Mass General
The Benson-Henry Institute for mind body medicine is a world leader in the study, advancement and clinical practice of mind/...
Bereavement help-seeking following an 'expected' death BMC Palliative Care
This research article examines the prevalence and nature of bereavement help-seeking among the population who experienced an...
Bereavement needs assessment in specialist palliative care: a review of the literature. Palliative Medicine
Abstract:  Bereavement needs assessment for specialist palliative care services has been highlighted as important by...
Breaking Bad News: Use of Cancer Survivors in Role-Playing Exercises. Journal of Palliative Medicine
Abstract:  Purpose: To teach medical students how to deliver a diagnosis of cancer using role-play with a cancer...