THE PALLIATIVE CARE APPROACH: Definitions / Philosophy: From "Cure" to "Comfort" / The Transition from "Diagnose and Treat" to "Palliate" / Historical Perspective: What Has Changed?

CULTURAL DIVERSITY IN END-OF-LIFE CARE: Planning for Diverse Populations / African American CultureandEnd-of-Life / Hispanic Views on DeathandDying / Understanding the Jewish Culture / Mourning in the Asian Culture / Death Practices in the Muslim Culture / Building Cultural Bridges with Other Cultures

APPROACH TO THE PATIENT: Delivering Bad News / The Family Conference / Dealing with Anger / The Spiritual Assessment / Giving Realistic Hope / The "DNR" or "AND" Discussion in Seriously Ill Patients / Advanced Directives in Health Care / Decision Making Ability / Goal Setting / The Hospice Conversation / Telling the Children / What if a Patient Asked You to Pray? / Death Pronouncement / Completing the Death Certificate / Informing Significant Others of a Patient's Death / Writing a Condolence Letter / Caring for the Family

PREDICTING LIFE EXPECTANCY: "How Long Do I Have?" / Guidelines for Hospice / Physician Prediction of Life Expectancy / Palliative Performance Score / Specific Diseases: Non Cancer Diagnoses (CHF, COPD, ALS, Dementia, Liver Disease, Renal Disease, Cerebral Vascular Disease, AIDS, General Debility, Others)

DELIVERY OF PALLIATIVE CARE: The Hospital Palliative Care Unit / Consulting in the Hospital / Hospice in Delivery of Palliative Care / Hospice in the Nursing Home

TERMINAL CARE: The Syndrome of Imminent Death / Near Death Awareness (NDA) / Terminal Delirium / Grief: Uncomplicated vs. Complicated

NON-PAIN SYMPTOM MANAGEMENT: Tips for Maximizing Chances of Success / Dyspnea, Air Hunger, Shortness of Air / Oral Care Basics / Fever Near the End of Life / AgitationandAnxiety / Sexual Needs / SpiritualandExistential Suffering / NauseaandVomiting / Dizziness / Hiccups / Fatigue / Anorexia / Constipation / Delirium / Diarrhea / Incontinence / Depression / Non-healing Wounds / Pruritis / Insomnia / Nightmares

PAIN CONTROL: Myths About Opioid Use / Legal Liability of Under-Treating Pain / Principles of Pain Management / Assessment of Pain / Converting One Opioid to Another (Equianalgesic Dosing) / Opioid Dose Escalation / Managing Opioid Side Effects / Opioid Withdrawal / Morphine / Hydrocodone for Pain / Oxycodone for Pain / Methadone for Pain Control / Gabapentin (Neurontin) for Pain / Naloxone (Narcan) / Meperidine (Demerol): Not Recommended for Pain / Propoxyphene (Darvon, Darvocet) / Blocks / Addiction vs. Pain / Pseudo-addiction

PALLIATIVE INTERVENTIONS: Tube Feeding in Palliative Care / Palliative Chemotherapy / Palliative Radiation / "Response Rate" in Cancer Chemotherapy / Ventilator Withdrawal / Bowel Obstruction / Treating the "Death Rattle" / Aggressive Wound Management

THE PALLIATIVE PEDIATRIC PATIENT: Children and Death / Neonatal Population / Pediatric Intensive Care Unit / Pediatric Withdrawal of Life Support / The Dying Adolescent

CHARTING: Documentation in Palliative Care / CodingandBilling for Hospice/Palliative Care

ETHICS AT THE END-OF-LIFE: EthicsandLegal Issues / Hastened Death: The Rule of Double Effect / When to Stop: Medical Futility / Caring for Yourself: Avoiding Burnout