Palliative care for the elderly - developing a curriculum for nursing and medical students

<p>Abstract</p> <p>Background</p> <p>Delivering palliative care to elderly, dying patients is a present and future challenge. In Germany, this has been underlined by a 2009 legislation implementing palliative care as compulsory in the medical curriculum. While the number of elderly patients is increasing in many western countries multimorbidity, dementia and frailty complicate care. Teaching palliative care of the elderly to an interprofessional group of medical and nursing students can help to provide better care as acknowledged by the ministry of health and its expert panels.</p> <p>In this study we researched and created an interdisciplinary curriculum focussing on the palliative care needs of the elderly which will be presented in this paper.</p> <p>Methods</p> <p>In order to identify relevant learning goals and objectives for the curriculum, we proceeded in four subsequent stages.</p> <p>We searched international literature for existing undergraduate palliative care curricula focussing on the palliative care situation of elderly patients; we searched international literature for palliative care needs of the elderly. The searches were sensitive and limited in nature. Mesh terms were used where applicable. We then presented the results to a group of geriatrics and palliative care experts for critical appraisal. Finally, the findings were transformed into a curriculum, focussing on learning goals, using the literature found.</p> <p>Results</p> <p>The literature searches and expert feedback produced a primary body of results. The following deduction domains emerged: Geriatrics, Palliative Care, Communication & Patient Autonomy and Organisation & Social Networks. Based on these domains we developed our curriculum.</p> <p>Conclusions</p> <p>The curriculum was successfully implemented following the Kern approach for medical curricula. The process is documented in this paper. The information given may support curriculum developers in their search for learning goals and objectives.</p

Ecomapping: an innovative research tool for nurses

Aim. This paper explores the use of ecomaps as a research tool for capturing data, using the example of the dynamic nature of social networks from which informal carers of people living with motor neurone disease draw their support.\ud Background. The need for social support in relation to health maintenance and disease management has been identified in the literature but little has been published about ways to investigate support networks. Existing discussion in the literature about the use of ecomaps as a clinical tool in social work creates a valuable framework for data collection which can be readily adapted by nurse researchers.\ud Method. We used ecomaps as part of a repertoire of research tools to gather data about the social networks of carers of people living with motor neurone disease. Primary carers participated in three interviews and collaborated in ecomap construction over a period of ten months during 2003. Analytical correlations were made between ecomaps and interview data. \ud Findings. Ecomaps provided a visual means of facilitating discussions around the structure and strength of networks. Being able to represent the social networks visually through ecomapping enabled people to identify each member of the network, examine the strength of each relationship and ascertain the sources of nurture and tension over time. Limitations to this type of data collection arise when participants try to quantify relationships that have been visually produced.\ud Conclusion. Ecomapping is a valuable research tool because it provides visual representation of supportive care networks, capturing strategic data through symbols expressing relationships that may be inadequately portrayed in words. The ecomap incorporates the use of consistent symbols that standardise recipient responses, enabling data comparisons to be made