320 Vol. 43 No. 2 February 2012Schedule With Abstracts

Paving the Long Road: BereavementCare (P11)Jody Chrastek, DNP CHPN�, Children’s Hospi-tals and Clinics of Minnesota, Minneapolis,MN. Stacy Remke, MSW LICSW, Children’s Hos-pitals and Clinics of Minnesota, Minneapolis,MN. Gretchen Norman, MA ATR, CenturaHealth at Home, Denver, CO.(All authors listed above for this session have dis-closed no relevant financial relationships.)Sponsored by HPNA

Objectives1. Describe common patterns of grief.2. Identify strategies for supporting those expe-

riencing acute grief.3. Identify signs and indications of complicated

grief.4. Describe supportive interventions to pro-

mote healthy grief.5. Discuss the role of expressive therapies in fos-

tering healthy grief.This presentation will describe current ap-proaches to understand grief across the lifespan. Current literature on the impact of theloss of a loved one will be reviewed. Recommen-dations for supportive care and anticipatoryguidance will be offered. Case examples that il-lustrate normal grief responses and concerningexamples will be offered. The role of art and ex-pressive therapies will be described. Experientialexercises will be offered. Resources for learningmore about grief and bereavement across thelife span will be provided.

Coming ‘‘Face to Face’’ With HospiceRegulations (P12)Judi Lund Person, MPH, National Hospice andPalliative Care Organization, Alexandria, VA.Katherine E. Lucas, PhD, Centers for Medicareand Medicaid Services, Baltimore, MD. Modera-tors, Susan Cox, MSN RN CHPN� CHPCA�, Hos-pice and Palliative Care of Greensboro,Greensboro, NC. Maryjo Prince-Paul, PhDAPRN ACHPN� FPCN, Case Western ReserveUniversity, Cleveland, OH.(All authors listed above for this session have dis-closed no relevant financial relationships.)Sponsored by HPNA

Objectives1. Explain the hospice face-to-face encounter

requirements and learn its history.

2. Explain the role of the nurse practitioner inthe face-to-face encounter, including billingand documentation requirements.

3. Identify mandatory Medicare quality report-ing requirements for hospices, and reviewhow staff should prepare for reporting.

4. Explore opportunities for advocacy at thefederal level and the current bill activitiesthat affect nurse practitioners, clinical nursespecialists, and physician assistants.

5. Review the 2010 survey deficiencies forhospices.

6. Identify ways to insure compliance with au-dits and surveys.

The ever-changing world of Medicare hospiceregulations published by the Centers for Medi-care and Medicaid Services (CMS) presents chal-lenges to the leaders, providers, and everyoneinvolved in the provision of hospice services. Aspublic discussions about deficiencies, fraud,and abuse rise, hospices must be equippedwith the necessary knowledge and resources tolearn how to audit for compliance and to survivesurveys and audits. In this preconference ses-sion, a panel of experts will discuss and explorethe newest guidelines regarding face-to-face en-counter, other recertification requirements, bill-ing changes, rate cuts for hospice Medicarereimbursement, and the role of the nurse practi-tioner in hospice. The new hospice quality re-porting requirements, published by CMS inAugust 2011 for implementation in 2012, willalso be discussed with recommendations onhow hospice leaders can best prepare for thesemeasures.

1e5 pm

Bearing the Profound: The Risks andBenefits of Empathy (P13)Lisa Stephens, MSN APRN ACHPN�, Dart-mouth Hitchcock Medical Center, Lebanon,NH. Donna Soltura, MSW, Dartmouth Hitch-cock Medical Center, Lebanon, NH. LindaPiotrowski, MTS BCC, Dartmouth HitchcockMedical Center, Lebanon, NH. Ira Byock, MDFAAHPM, Dartmouth Hitchcock Medical Cen-ter, Lebanon, NH.(All authors listed above for this session have dis-closed no relevant financial relationships.)Sponsored by AAHPM

Vol. 43 No. 2 February 2012 321Schedule With Abstracts

Objectives1. Define compassion fatigue and vicarious

trauma and discuss the current evidence re-garding protective factors and resiliency inpatients and providers.

2. Define and discuss ways to enhance selfawareness when our feelings are triggeredby caring for patients with life-threateningillness.

3. Identify techniques and practices that en-hance the rejuvenating aspects of serving pa-tients and their loved ones, even in the midstof great suffering, and apply these tech-niques into everyday practice.

What do we do with our own emotional re-sponse to the suffering of those we serve: pa-tients, families, and colleagues? Adverse effectson the provider are presumed consequencesof ‘‘walking too close to the fire,’’ but we believethat there are authentic rejuvenating aspects ofcaring for people experiencing life-limiting ill-ness. What makes us question our (or a collea-gue’s) ability to continue to do this work?What makes us resilient and energized? Whatmakes us consistently grateful to have chosenthis path? How does personal self-care improvepatient outcomes?This session will address these questions by de-fining terms such as compassion fatigue andvicarious trauma; discussing the current litera-ture on resiliency on the side of patients andproviders; and reviewing case studies to explorethe emotional effect of suffering on the Clini-cian. Internal and external resources will beidentified. Attendees will experience, firsthand, techniques and practices that serve to re-juvenate the professional provider. This sessionwill include experiences with mindfulness, writ-ing for healing, stress reduction, team building,and the use of professional self-awareness tools.Attendees will also have an opportunity to ap-ply this knowledge within this workshop andshare their perspectives to contribute to thecollective wisdom.

A Critical Review of Evidence-BasedNon-Pain Symptom Management at Endof Life (P14)Mary Lynn McPherson, PharmD BCPS CPE,University of Maryland, Baltimore, MD. MellarDavis, MD FAACP FAAHPM, Cleveland Clinic,Cleveland, OH. Eduardo Bruera, MD, MD An-derson Cancer Center, Houston, TX. Egidio

Del Fabbro, MD, MD Anderson Cancer Center,Houston, TX.(All authors listed above for this session have dis-closed no relevant financial relationships.)Sponsored by AAHPM

Objectives1. Given an actual or simulated patient with an

advanced illness and a non-pain symptom,(eg, gastrointestinal, cardiorespiratory, neuro-psychiatric or other), describe the evidencesupporting the appropriate use medicationsto treat the complaint.

2. Given a patient with one of the non-pain symp-toms described, describe the rationale formedication selection including considerationof patient- and drug-related variables.

3. Describe clinically significant pharmacody-namic and pharmacokinetic drug interac-tions associated with medications used totreat non-pain symptoms and recommendappropriate management strategies, includ-ing pre-emptive interventions.

Much attention has been paid to the manage-ment of pain experienced by patients with an ad-vanced illness. But pain is just one symptomexperienced by patients at the end of life. Thisworkshop is an opportunity for participants toexplore the evidence base that supports drugtherapy decision-making for common non-painsymptoms. These include gastrointestinal, car-diorespiratory, neuropsychiatric, and othersymptoms. Neuropsychiatric symptoms are verycommon with advanced illness. For example,simply understanding why a patient is depresseddoesn’t mean we shouldn’t treat it at end of life.Participants in this workshop will learn how toconsider the evidence supporting the consider-ation of patient- and drug-specific characteristicsthat will enable practitioners to safely, effectively,and expediently select medications to treat de-pression. This same methodology will be usedto address other neuropsychiatric symptomssuch as anxiety and delirium. Gastrointestinalcomplaints including nausea, vomiting, and con-stipation symptoms will be addressed, as well asdyspnea and constitutional symptoms such as fa-tigue, anorexia, and cachexia.This workshop will use a case-based approach toevaluate patient complaints and demonstrateusing patient-specific data to guide therapeuticdecision-making.Dosing strategies dosing includ-ing, starting doses, titration strategies, monitor-ing, and directions for modifying therapy