1. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Osteopathic EPEC Osteopathic EPEC Education for Osteopathic Physicians on End-of-Life Care Based on The EPEC Project, created by the American Medical Association and supported by the Robert Wood Johnson Foundation. Adapted by the American Osteopathic Association for educational use. American Osteopathic Association AOA: Treating Our Family and Yours

2. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Plenary 4 Next Steps

3. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Objectives List the important themes from the EPEC materials Identify barriers to good end-of-life care Develop potential solutions

4. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours EPEC themes, next steps Relief of suffering is a goal of medical care Palliative care knowledge is now extensive Role of families Teamwork Physician as patient advocate

5. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Relief of suffering 4 dimensions of suffering Physical Psychological Social Spiritual Expected by patients, families

6. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Palliative care Not the absence of care More powerful than ever in the history of medicine A positive, humanistic philosophy Technically sophisticated area of expertise

7. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Osteopathic Philosophy Treatment of the entire person Utilize all available medical procedures and technologies Understanding of relationship to structure and function Utilization of osteopathic manipulative treatment options

8. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Families... How we die is an important personal legacy Dying well often demands The chance to be close to family, friends Family / proxy assistance with decisions Good communication

9. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours... Families None of this is possible without good symptom management

10. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Teamwork... The whole person goes through the dying process, not just his / her physiology No one person can meet all the needs

11. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours... Teamwork Teamwork usually includes Physicians Nurses Social workers Chaplains Others Hospice philosophy can be integrated into mainstream practice

12. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Advocacy Professional duty to patient care Professional duty to ensure availability of services Personal desire to be able to die with quality care

13. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Barriers Institutional Regulations Reimbursement Attitudes

14. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Physicians’ personal support needs... Patients are asking us to do better Find a forum for candid discussion of experiences Transference is powerful; personal comfort is important

15. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours... Physicians’ personal support needs Professional distance, empathic closeness must balance Know yourself

16. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Action Plan BarrierPlan

17. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Barriers “I” = Institutional “O” = Others “U” = Personal

18. EPECEPECEPECEPEC American Osteopathic Association AOA: Treating Our Family and Yours Next Steps Summary