Death & Dying Seminar

Question 1

What is the major qualifying criteria for hospice care

Answer 1

less than 6 months life expectancy and no longer undergoing active treatment

Question 2

List some signs that someone may be ready for hospice

Answer 2

• many ED visits/hospitalizations with disease progression
• no longer wanting to go to the hospital/clinic
• no longer wanting to receive treatment

Question 3

List the 5 most common end of life symptoms

Answer 3

• decreased appetite
• mottled extremities
• breathing changes (“death rattle”)
• incontinence
• agitation

Question 4

List the two meds commonly given to alleviate anxiety/restlessness/agitation at end of life

Answer 4

• ativan
• haloperidol

(usually SL)

Question 5

List a few meds commonly given to alleviate fatigue at end of life

Answer 5

• ritalin
• dexamethasone

Question 6

List a few meds commonly given to alleviate weight loss/anorexia at end of life

Answer 6

• dexamethasone
• marinol
• medical cannabis

Question 7

List a few meds/treatments given to alleviate mucositis at end of life

Answer 7

• salt & soda swishes
• topical lidocaine or magic mouthwash
• narcotics

Question 8

List some things given to alleviate dry mouth at end of life

Answer 8

• pilocarpine
• ice chips
• water soaked swabs

Question 9

List some meds given to alleviate n/v at end of life

Answer 9

• ondansetron
• prochlorperazine
• lorazepam
• haloperidol

Question 10

List some meds/treatments given at end of life to alleviate dyspnea

Answer 10

• O2
• benzos (ativan)
• morphine
• elevate head of bed

Question 11

List some things given at end of life to alleviate thick secretions

Answer 11

• guaifenesin
• atropine (SL or BUC)

Question 12

List some things given at end of life to alleviate pain

Answer 12

• hydrocodone +/- APAP
• oxycodone +/- APAP
• hydromorphone
  - fentanyl (patch)
• long acting MS contin
• pain pumps
  - morphine sulfate 20mg/ml
  - oxycodone 20mg/ml

Question 13

Describe the 5 ECOG scores on performance status assessment

Answer 13

• 0: fully active
• 1: restricted in physically strenuous activity
• 2: ambulatory, capable of all self care, up more than 50% of waking hours
• 3: limited self care, confined to bed/chair more than 50% of waking hours
• 4: completely disabled, totally confined to bed/chair

Question 14

List the major parts of an advanced directive that make it legal

Answer 14

• printed, signed & dated by hand
• 2 witnesses that are not healthcare agent (at least 18)
• notary public