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The Meaning of "Everything": Responding to Patient Requests for Aggressive Treatment at the End of Life

James A. Tulsky, M.D. (Director, Center for Palliative Care and Associate Professor of Medicine and Nursing; Senior Fellow, Center for the Study of Aging and Human Development, Duke University School Medicine) discussed the meaning of "everything" as heard in statements such as, "You are going to do everything for my Father, are'nt you?" Additionally, Dr. Tulsky reviewed the past decade of studies on communication, identified and listed barriers to change; and provided solutions to address requests that imply or directly ask for "everything" to be done to keep a person alive. Dr. Tulsky presented the NURSE Model of name, understand, respect, support, and explore the senstive situation of "doing everything" and almost certain impending death.
Health Sciences (Rare Shelves)

EMTs, Nurses, Therapists, and Assistants [electronic resource]

In this video, viewers are able to focus on those health care jobs which are more heavily involved in caring for people. Emergency medical technicians provide basic life support procedures before patients are transported. We learn about the various levels of experience and how they differ. The duties of nurses, therapists, and assistants are also covered, including training, job skills, and other pertinent information.
2006; 2000

Health Technicians and Technologists [electronic resource]

This video provides a comprehensive look at the field of health technicians and technologists. These jobs deal with diagnosing and treating illnesses using computers, machinery, and other tools. Viewers learn about a typical day on the job, the type of training and certification needed, and how to earn these qualifications. We see dental technicians and hygienists, dental laboratory technicians, EKG technicians, nuclear medicine technologists, dosimetrists, sonographers, cytotechnologists, phlebotomists, and others. This is an excellent resource for students who wish to learn more about this field.
2006; 2000

Beyond Wound Healing [electronic resource]

Supplemented with clinical photos and precise diagrams, this program quantifies wound assessment and describes approaches to wound healing. The physiological healing cascade and infection flags are discussed, along with case studies spanning an age range of 31 to 78. A deep bruise, a leg ulcer complicated by eczema, an infected surgical incision, and a necrotic neck tumor are presented, allowing the introduction of subjects such as the hydrobalance, hydrosorptive, hydroactive, and hydroionic methods of wound dressing; graduated compression therapy; and odor reduction.
2005; 1997

Freedom of Speech [electronic resource]: Augmentative Communication Success Stories

For people with special needs, augmentative communication technology is opening the door to fuller expression, better education, and higher self-esteem. This program illustrates the positive impact of augmentative communication technology on the lives of Adam and Mike. Adam, once considered mentally retarded by school staff, has become a college-educated professional-thanks in part to an augmentative device-while the parents of 7-year-old Mike, who does not speak due to autism, believe that technological advances will soon help their son.
2006; 1997

A History of Care [electronic resource]: Nursing in America

Progressing from the late 18th century to the present day, this program offers a capsule summary of nursing in America. The tireless work of the U.S. Army and Navy nursing corps, the American Red Cross, and the countless nurses affiliated with hospitals and other organizations is celebrated while honoring the courage and self-sacrifice of those who put themselves in harm's way in order to help the helpless. Dorothea Dix, Clara Barton, Harriet Tubman, Sojourner Truth, Clara Maass, Lillian Wald, and Lavinia Dock are only a few of the nurses singled out by history-and this video-for special commendation. Inspiring! Useful in both academic and career guidance contexts.
2010; 2006

Building Bridges [electronic resource]

The mark of a professional health care worker is a caring attitude and a desire to be of service. This program offers a combination of tips on how to enhance caregiver/patient interactions and thought-provoking questions to help caregivers develop or improve their patient-centric behaviors. An informative staff-development tool for nursing home, hospital, and even homecare settings-anywhere caregivers are building compassionate bridges of understanding and empathy. Designated for 2 contact hours of continuing nursing education.

Restraint-Free Environments in the Long-Term-Care Setting [electronic resource]

Eliminating restraints from the nursing home environment is not an unattainable dream! This program outlines the components of a restraint-reduction plan: developing a team approach to resident safety; assessing needs and developing interventions based on each resident's presenting problem, behavioral triggers, and available resources; and working toward desired outcomes though regular evaluation of interventions and adjustment of the resident's care plan. The best restraint alternatives? Those that take into account the resident's weaknesses while focusing on the resident's strengths. Designated for 2 contact hours of continuing nursing education.

Caring for the Cognitively Impaired Client [electronic resource]

Dementing illnesses, whether functional or organic, involve mental and behavioral changes that can be difficult for a caregiver to make sense of-and to cope with. This program addresses the causes of cognitive impairment and presents approaches to caring for adult clients that preserve their dignity. Depression and delirium are given special attention, as well as behaviors common to senile dementia such as disorientation, confusion, clinging, and wandering. Designated for 2 contact hours of continuing nursing education.

Assisting the Resident With Meals [electronic resource]

Addressing the human as well as nutritional needs of elderly people, this program thoroughly covers proper meal-serving technique in the communal dining hall, the private residence, and bed. Special feeding circumstances and solutions are also examined. Designed for assisted-living and long-term-care facilities, but also helpful for caregivers in a home health care setting. Good nutrition is the cornerstone of health! Designated for 2 contact hours of continuing nursing education.

Nutrition for the Older Adult [electronic resource]

This program explains what it means to "eat right," examines the special nutritional requirements of older adults, and considers food-related health concerns that can affect nutritional status later in life. In addition to detailed food and fluid guidelines for healthy living, the following are addressed: nutrient deficiencies common to the aging adult; malnutrition-related conditions such as osteoporosis, anemia, and dehydration; and physical and mental factors that may contribute to an unhealthy decrease in food intake. Ideal for nursing assistants in long-term-care facilities and for home health aides. Designated for 2 contact hours of continuing nursing education.

Hand, Foot, and Nail Care [electronic resource]

Ironically, the parts of the body we use the most also tend to be the most neglected, medically speaking. As we age, it becomes more and more important to address the wellbeing of our hands and feet, and in caring for the elderly it is vital to give attention to these frequently overlooked areas. This program identifies common hand and foot health problems, explains the changes that occur in aging hands and feet, and illustrates techniques for keeping these extremities functioning well. Rheumatoid arthritis, hand and foot exercises, topical and dermatological skin care, nail maintenance and warning signs in fingernails, and the benefits of hand and foot massage are all discussed. Designated for 2 contact hours of continuing nursing education.

Diabetes [electronic resource]: A Comprehensive Update

Once a feared and fatal disease, diabetes is today a serious but largely manageable condition?if quality care is available. This program presents key knowledge and strategies that will help nurses administer diabetes medications effectively and support their patients in managing their condition. Viewers learn to distinguish between type 1 and type 2 diabetes, identify its signs and symptoms, understand how it is diagnosed, gain skills needed for glucose monitoring, create blood glucose-level goals, advise in diet and nutrition choices, and assist in implementing stress-reduction measures. Helpful discussions of prevention, medication, medical complications, and sick-day management are also included. Designated for 3 contact hours of continuing nursing education.

Alzheimer's Disease for Assisted Living Facilities: Level 1 [electronic resource]

It takes a very special person to care for the Alzheimer's resident. This program-a must-see for health care workers in assisted living facilities-discusses causes of Alzheimer's disease and related dementias; symptoms and behaviors that accompany the stages of AD; strategies for coping with AD-related restlessness, agitation, and wandering; strategies for verbal and nonverbal communication with AD residents; family member guilt over placing a loved one with AD in an ALF; maintenance of a safe and engaging environment for AD residents; and ethical challenges faced by AD caregivers. Commentary by ALF professionals and family members provides additional depth...and poignancy. Extremely thorough! Meets the Florida Level I requirement for ALFs. Designated for 4 contact hours of continuin [...]

Alzheimer's Today [electronic resource]: A Caregiver's Guide

This program, prepared specifically for home health care providers, offers an insightful look at Alzheimer's disease and related disorders. Section one deals with understanding Alzheimer's disease and ADRDs and discusses how to communicate with people affected by Alzheimer's. Section two focuses on behavior management that begins with symptom recognition and concludes with specific strategies and techniques for dealing with challenging behaviors. And section three looks at how to maximize daily function specifically by promoting independence throughout all stages of Alzheimer's.

Daily Exercise for Parkinson's Patients [electronic resource]

This instructor-led physical fitness video offers a daily regimen of strengthening, range-of-motion, balance, and breathing exercises for people with Parkinson's disease. Gentle seated calisthenics and stretches include neck rotations and head sweeps, shoulder rolls, trunk stretches, rowing and swimming motions, arm and wrist circles, finger stretches, marching, hip rotations, hamstring stretches, ankle flexes and rotations, and lower back stretches. Gentle seated Thera-Band muscle-toning exercises include shoulder blade pinches, shoulder joint flexes, triceps curls, rowing motions, marching, thigh flexes, and ankle flexes. And gentle standing exercises include sit-to-stands, hip extensions, rear-kicks, squats, and calf stretches. The program ends with deep breathing.
2011; 2007

Advanced Prostate Cancer and Bone Loss [electronic resource]

This episode of Healthy Body, Healthy Mind outlines the treatments for advanced prostate cancer, with a focus on bone loss associated with this disease. Through firsthand accounts, the audience gains an understanding of how patients can make informed choices together with their caregivers, work with their doctors, and become partners in their own care. The program introduces emerging treatments that are being developed for prostate cancer. It also examines therapies to help men suffering with the bone loss that can accompany advanced prostate cancer.

Gaucher Disease [electronic resource]: A Mysterious Genetic Disorder

An inherited metabolic disorder known as Gaucher disease was first described by the French physician Philippe Gaucher in 1882. It is the most common of a class of ailments called lysosomal storage diseases. Gaucher disease is characterized by a wide array of symptoms, and the severity ranges from undetectable to lethal. Though this devastating disease can affect any ethnic group, the most common form of it is seen in people of eastern European (Ashkenazi) Jewish descent. This program explores the history of the condition and introduces patients who talk about their struggles with it. Also highlighted are the new treatments now offering hope for people living with this mysterious illness.

Innovations in Liver Transplantation [electronic resource]

This program highlights the advances in liver transplantation surgery over the years. The hepatitis C epidemic has fueled an international need for liver transplantation, and innovations in surgical treatments and anti-rejection therapies are helping ever-increasing numbers of people to live healthy lives with new livers. The organ's unique ability to regenerate has led to one of the most exciting operations: the living donor liver transplant. Through patients' stories and interviews with experts, the program shows how liver transplantation can save lives and bring health and healing to families around the world.

Relieving Low Back Pain [electronic resource]

One of the most common conditions in America is low back pain. It can happen in young people, older adults, and everyone in between. And, because it is so prevalent, many may not think of it as serious. But anyone who has lived with chronic low back pain knows how much it can affect all aspects of one's daily life. This program introduces experts who educate viewers on what low back pain is, the impact it can have on a person's quality of life, and the latest developments in our understanding of optimal care. The program features interviews with patients who discuss their therapies - including non-invasive treatments and other programs of excellence in low back pain care.