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End-of-Life Decision Making for Older Adults: Competent and Compassionate Care

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1.  Hospice and palliative care videos can be found in a variety of locations. One video (and segments of the video) that has been used in the past comes from Graceful Passages, The Hospice Journals (2009, The Center for Hospice & Palliative Care, Inc). Any hospice or palliative care video can be used to implement this strategy.

2.  Case study material can also come from a variety of sources.  However, there are several well developed unfolding cases on the NLN ACE.S website which are excellent. One unfolding case, Julia Morales and Lucy Grey, is particularly useful for addressing end-of-life care, but all of the unfolding cases may be appropriate if adapted. An important factor for any case study, and one that is included in the ACE.S unfolding cases, is a focus on context and the unique situations and experiences each of the older adults and their families face. End-of-life care is holistic and must incorporate the unique contexts, challenges, and life experiences of older adults and their families. Below is a case study example of Julia Morales, which can be used to stimulate discussion or creation of a concept map. 

Case studies can also be used to help students explore issues with end-of-life caregiver strain and burden. The article from The Atlantic, “Letting Go of My Father” (Rauch, 2010), details the challenges and strain a caregiver might face when caring for family members during end of life transitions. 

3.  Concept mapping is an emerging and useful teaching tool in nursing education. Concept maps facilitate critical thinking by allowing students to visually create a framework of important constructs or components of a given situation and create propositional links between them. 

Concept mapping stimulates critical thinking and creativity and can be particularly useful when helping students to think about the holistic and complex challenges older adults and their families face during end-of-life transitions. Several recent articles have been published detailing the use of concept mapping in nursing education. 

  • All, A., Huycke, L. I., & Fisher, M. (2003). Instructional tools for nursing education: Concept maps. Nursing Education Perspectives, 24(6), 311-317.
  • Gul, R. B. & Boman, J. A. (2006). Concept mapping: A strategy for teaching and evaluation in nursing education. Nurse Education in Practice, 6(4), 199-206. doi: 10.1016/j.nepr.2006.01.001
  • King, M. & Shell, R. (2002). Teaching and evaluating critical thinking with concept maps. Nurse Educator, 27(5), 214-216. 

4.  Additional useful tools and web sites when caring for older adults at the end of life: 

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