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Education in Palliative and End-of-life Care - Oncology

The. EPEC-O. TM. Education in Palliative and End-of-life Care - Oncology. Project. The EPEC-O Curriculum is produced by the EPEC TM Project with major funding provided by NCI, with supplemental funding provided by the Lance Armstrong Foundation.

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Education in Palliative and End-of-life Care - Oncology

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  1. The EPEC-O TM Education in Palliative and End-of-life Care - Oncology Project The EPEC-O Curriculum is produced by the EPECTM Project with major funding provided by NCI, with supplemental funding provided by the Lance Armstrong Foundation.

  2. EPEC - Oncology Education in Palliative and End-of-life Care - Oncology Plenary 2 Models of Comprehensive Care

  3. Main message • Funding and service delivery systems must be in place to provide palliative care as a reliable component of comprehensive cancer care

  4. Objectives • Comprehensive cancer care includes palliative care from the day of diagnosis • Define hospice and palliative care and relate their history • Describe funding and service delivery models for providing comprehensive cancer care • Understand when palliative care services are appropriate for cancer patients

  5. Video

  6. Comprehensive cancer care • Gaps in contemporary cancer care • Approaches to relief of suffering • Piloted with hospice programs • More widely applied through palliative care programs • Now being integrated into comprehensive cancer care

  7. Hospice • Historical evolution • Medicare Hospice Benefit • 40% of dying cancer patients referred • Median enrollment 22 days • 37% of patients die within 7 days

  8. Conventional cancer care

  9. Hospice in the US today • A place • An organization or program • An approach to or philosophy of care • A system of reimbursement

  10. Hospice care

  11. Hospice care • Safe and comfortable dying • Self-determined life closure • Effective grieving

  12. Levels of care • Routine care • General inpatient care • Continuous care • Respite care

  13. Core services • Interdisciplinary care • Chaplaincy, nursing, medical social services, counseling, volunteers • Primary care physician • Palliative care physician (consultation) • Bereavement counseling • Medical equipment, supplies • Medications and therapies related to the terminal diagnosis

  14. Palliative care • Therapies to relieve suffering and improve quality of life • May be combined with therapies aimed at remitting or curing cancer, or it may be the total focus of care

  15. WHO 2002 definition of palliative care "Palliative care is an approach which improves quality of life of patients and their families facing life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual"

  16. Palliative care

  17. Delivering palliative care Primary Secondary Tertiary

  18. Comprehensive cancer care • Anti-cancer therapy • Supportive care • End-of-life care • Bereavement care

  19. Comprehensive cancer care

  20. Clinical (secondary) palliative care Home SNF Consultation Services Inpatient Care Outpatient Office

  21. Case examples • Warren Grant Magnuson Clinical Center, NIH, Bethesda • Memorial Sloan-Kettering, NYC • Dana-Farber Cancer Center, Boston • Fox Chase Cancer Center, Philadelphia • MD Anderson Cancer Center, Houston

  22. Development as a specialty • Curricula • Certification exams • Journals • Textbooks • Fellowship training • Formal recognition as a subspecialty

  23. Summary Funding and service delivery systems must be in place to provide palliative care as a reliable component of comprehensive cancer care

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