Key concepts covered include:

By the end of this module, you should be able to:

• Identify clinical features of delirium.
• Diagnose and treat reversible causes of delirium in paliiative care patients.
• Be aware of non-drug strategies to manage delirium.
• Recognise when symptomatic drug treatment of delirium is appropriate
• Prescribe appropriate drugs to aid management.
• Suggest probable mechanisms for nausea and vomiting in cancer patients
• Choose appropriate drugs to manage nausea and vomiting according to the most likely cause
• Develop a teaching session for new colleagues on nausea and vomiting
• Discuss with a colleague the main priorities for the care of a patient who is in the last days of life
• Discuss with a new member of your team the usual ways to support and address the physical symptoms at the end of life
• Lead a team review of the usual issues for a patient and their family in all domains (psychological, social and spiritual) in the last few days of life
• List the usual causes of constipation in palliative care patients
• Outline your management of constipation according to the most likely cause
• Deliver a teaching session to colleagues on treatment of constipation in palliative care
• Describe the management of bowel obstruction secondary to malignancy to a new colleague
• Teach a new colleague key elements of skin and mouth care in a patient with advanced cancer
• Discuss practical issues with a new colleague and a family around the basic principles of skin and mouth care in someone with advancing cancer
• Be able to support families and answer the usual questions they might have around skin and mouth care at the end of life
• Have a greater understanding of what breathlessness/dyspnoea is
• Understand the principles of management of breathlessness/dyspnoea
• Know the effects of anxiety on breathlessness/dyspnoea
• List the key elements needed to establish or further develop a palliative care service in your country
• Inform a new colleague of the role of POS and how to use it
• Show a new colleague how to access the material from A.P.C.A to help develop training and understanding in palliative care
• List 6 points to consider to help effective communication.
• Describe to a new colleague the key elements to breaking bad news.
• Describe to a new colleague why people may use ‘denial’ and ‘collusion’  as communication strategies and suggest ways to manage such a situation.
• List some of the barriers in your area/locality to effective communication.
• Discuss with your team effective ways of talking with children about grief and bereavement.
• List some of the aetiological factors thought to contribute to the development of cancer.
• Describe to a student colleague how cells grow and multiply and how malignancy affects these cells.
• Describe to a new colleague how the different types of cancer treatment work.
• List some of the usual causes of fatigue and weakness in cancer patients.
• Review the options for managing reversible causes of weakness in your area.
• Discuss with a new colleague the usual impact on the patient and family of weakness and fatigue.
• Discuss with a family the management of a patient who appears to be losing their appetite.
• Recognise the key symptoms and signs and the patients most likely at risk of:
• Hypercalcaemia
• Neutropenic sepsis
• Superior vena cava obstruction
• Spinal cord compression
• Catastrophic haemorrhage
• Develop and administer the appropriate management plan for each of these conditions.
• Outline to a colleague what is meant by psychosocial care.
• List 4 common areas of concerns that patients may express.
• List at least 4 core skills for psychosocial care workers.
• List to a new colleague the key differences between a curative and a palliative approach.
• Describe how you might handle a difficult conversation about impending death with a child.
• List and explain the 5 key elements of a sound ethical framework.
• Discuss with an overseas visiting colleague the practical difference between personal and communal autonomy.
• Outline to a new colleague how an ethical framework helps in a difficult collusion or confidentiality situation.
• Outline to a new colleague how an ethical framework helps in managing changing symptoms in a patient with advancing cancer.
• List at least 3 options for symptom relief that do not involve medication.
• Talk to a new colleague about a framework for assessing and monitoring symptom control in patients with cancer.
• Discuss with a new junior colleague some of the usual patient and authority barriers to the use of morphine in your country.
• Discuss with that same colleague strategies to addressing those barriers.
• State the definition of palliative care to a colleague.
• Describe how palliative care fits in to the care of a patient with cancer.
• Describe the key things you need to think about when looking after someone with an incurable condition.
• Describe the key points of the grief reaction.
• Describe the key features of a complicated or delayed grief reaction and their consequences for the individual.
• Discuss with those working with or alongside you how best to support those grieving in your community or your place of work.
• Describe to a new colleague how the different types of cancer treatment work.
• List some of the issues to consider when planning the most appropriate management for a patient with incurable disease.
• Accurately assess pain to determine a likely working diagnosis as to its cause.
• Describe how cancer and its complications can cause pain.
• Manage pain , including appropriate use of analgesics.
• Distinguish between religion and spirituality to a group of colleagues.
• Describe the 4 elements of the FICA tool.
• Give examples of the sorts of questions you might ask a patient if you were using the FICA tool.
• Develop an effective management plan for the next patient you encounter.