Promoting Excellence : ESRD Table of Contents : One-Day Postgraduate Education Course for ASN Renal Week 2001

"Supportive Care for the Renal Patient: Modern Palliative Care Principles Applied to the ESRD Patient"

Course Objectives

The goal of this program is to present a "renal" version of the American Medical Associationís Education for Physicians on End-of-Life Care Program. At the completion of this program the participant should be able to:

  1. explain what renal palliative care is and how it differs from routine ESRD patient care;
  2. communicate more effectively to discuss difficult issues with patients and families;
  3. use evidence-based protocols and algorithms for palliative care;
  4. discuss current literature in this field;
  5. utilize a comprehensive list of resources on palliative care including journal references, Web sites, etc.;
  6. employ a patient/family-centered approach to palliative care; and
  7. develop a Renal Palliative Care program in his or her dialysis unit.

Course Co-Chairs

Richard Dart, MD, Marshfield Clinic, Marshfield, WI
Michael Germain, MD, Tufts University, Springfield, MA
Alvin Moss, MD, West Virginia University, Morgantown, WV

Session One: Introduction to Palliative Care; Communication Issues

7:00-8:00 am Registration and Breakfast

8:00-8:30 am What is Palliative (Supportive) Care and Why is it Important to Nephrologists
(Ira Byock, MD, University of Montana, Missoula, MT)

8:30-9:00 am Advanced Care Planning-Discuss Early and Often with Patients and Families
(Jean Holley, MD, University of Rochester, Rochester, NY)

9:00-9:30 am Improving Palliative Care in Your Practice and Renal Care Program - A Simple Incremental Approach
(Marilyn Pattison, MD, Franciscan Health System, Tacoma, WA)

9:30-10:00 am How to Incorporate Palliative Care into Your Practice and Dialysis Unit
(Lewis Cohen, MD, Tufts University, Baystate Medical Center, Springfield, MA)

10:00-10:30 am BREAK

10:00-12:00 pm Case-Based Interactive Workshop in Groups of Ten

Communication Skills Videotape of nephrologist discussion with the patient/family. Examples of successful and unsuccessful interviews

How to Break Bad News Videotape of patient discussions will be shown. Role playing for different scenarios:
  1. telling a patient they have ESRD and must start dialysis;
  2. asking for an advance directive from a dialysis patient;
  3. discussing discontinuation of dialysis; and
  4. reaching agreement on the goals of care for the dying ESRD patient.
12:00-1:30 pm LUNCH

Session Two: Practical Skills in Renal Palliative Care: Providing Comfort and Support to the ESRD Patient

1:30-2:00 pm Principles of Pain Management in Patients with Renal Insufficiency: Pharmacokinetic Considerations
(Richard Dart, MD, Marshfield Clinic, Marshfield, WI)

2:00-2:30 pm Symptom Assessment and Management of Dialysis and Non-Dialysis Related Symptoms
(Michael Germain, MD, Tufts University, Springfield, MA)

2:30-3:00 pm Management of the Patient Who Withdraws from Dialysis
(Carl Kjellstrand, Chicago, IL)

3:00-3:30 pm Personalizing End-of-Life Discussions: The Role of Peer Counseling
(Erica Perry, Richard Swartz, University of Michigan, Ann Arbor, MI)

3:30-4:00 pm BREAK

4:00-5:30 pm Case-based Discussions - What We Know about End-of-Life Issues in Dialysis Patients: Ethical and Palliative Care Principles - Review of the Literature
(Alvin Moss, MD, West Virginia University, Morgantown, WV and faculty)

This course is sponsored by an unrestricted educational grant from The Robert Wood Johnson Foundation.

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Promoting Excellence in End-of-Life Care is a National Program Office of The Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying persons and their families. Visit for more resources.

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