Module G: Advance Planning, Grief & Bereavement

CE Credits: 1.5

This module explores the reality that more people living with, declining from, and ultimately dying of a chronic condition raise complexities and challenges that require new ways of thinking about death and dying. Well-publicized cases of terminally ill people, who were kept alive by artificial means while their families argued over what care options the patient would have wanted, got more people thinking about their own end-of-life wishes.

For patients and their loved ones, no care decisions are more profound than those made near the end of life. For the millions of Americans who work in the health care sector, providing high-quality care for people nearing the end of life is a matter of professional commitment and responsibility

Learning objectives: After completing this module the case manager will be able to:
» Identify ethical, legal and regulatory issues associated with advance planning
» Review types of advance directives
» Describe care of the imminently dying patient
» Discuss grief and bereavement processes

Advance your professional practice:: As case managers, it is important to understand that despite efforts to educate patients and providers and expand the awareness and use of advance planning and directives, there are ample opportunities to improve communication and decision-making.

CMs can aid patients and families by being conversant about their specific state requirements and helping to bridge gaps in understanding options associated with advance planning.


Improve organizational performance: Improving our knowledge about preparing family and loved ones for approaching death. Although the signs of approaching death may appear obvious to health care professionals, many family members have never observed the death of a loved one. As a result, most people are not familiar with the signs of impending death. Educating family members about these signs in a clear but sensitive way is a critical part of EOL care.

The family should be told that the clinical expectation is that the patient is dying and will die. This should be communicated to the patient, relatives and other caregivers in a calm and reassuring manner.

Use of ambiguous language such as “may not get better” can lead to misinterpretation and confusion.