End of Life Care Exam Questions and
Answers
Define end of life - correct answer: refers to health care, not only of a person in the final hours
or days of their lives, but more broadly care of all those with a terminal condition that has
become advanced, progressive, and incurable
Death in the US - correct answer: chronic disease is leading cause (decline in death from HD and
cancer, increase in accidents/suicides/OD)
ppl are living longer with life-limiting illnesses, need to care for ppl for longer periods of time
women have longer life expectancy (increase r/t accidents/OD/suicide)
increase in healthcare interaction with death/dying in past few decades; policy is important
preferences at end of life - correct answer: most people prefer to die at home but only a portion
of people actually get to die at home
terminal illness vs life-limiting illness - correct answer: basically same thing, deals with
reimbursement
life-limiting is more of living with an illness that will definitively cause death
serious illness - correct answer: A health condition that carries a high risk of mortality and either
negatively impacts a person's daily function or quality of life, or excessively strains their
caregivers
,trajectories of EOL - correct answer: terminal illness - 5% (changed by recent innovations)
organ failure - 80% (decline r/t exacerbations, return to function but lower than baseline before
exacerbation)
frailty (long period of slow decline, AD/dementia, doesn't fit well into hospice care)
sudden death - < 10% (not common, pay attention to caregivers/family)
goals of EOL care - correct answer: Pain and symptom management
Clear decision-making
Preparation for death
Completion
Contribution to others
Affirming of the whole person
define hospice - correct answer: For patients with life expectancy < 6 months* (designated by
two providers); must certified as terminally ill
Replaces curative therapies**
Covered by Medicare Hospice Benefit - rate (Replaces Medicare A & B - time is state-dependent)
May be provided in any setting, primarily home
Focused on symptom management, patient and family goals; improving comfort/QOL
, Provided by an interdisciplinary team (both for profit and not for profit agencies may collab with
provider in nursing home/etc and provide specialty care or nursing home may have their own
team)
define palliative care - correct answer: Palliative care ... is specialized ... care for people living
with serious illnesses. It is focused on providing patients with relief from the symptoms and
stress of a serious illness—whatever the diagnosis. The goal is to improve quality of life for both
the patient and the family.
Palliative care is provided by a team of ...specialists who work with a patient's other [providers]
to provide an extra layer of support. Palliative care is appropriate at any age and at any stage in
a serious illness and can be provided together with curative treatment.
what does palliative care look like - correct answer: Designated chaplain, other team members
Specialized vs primary palliative care
Specialized - extra training
Primary - can be provided by any healthcare provider, no extra training, imp part of nursing care
Type depends on resources of where you are
typically in facility that is associated with palliative care
difference between hospice and palliative care - correct answer: Key differences:
Concurrent treatment
Who is eligible
Payment structure
palliative care allows for concurrent curative and life-prolonging measures; terminal/non-
terminal illnesses and can begin at any stage of disease
paying for hospice - correct answer: medicare hospice benefit
state medicaid
Answers
Define end of life - correct answer: refers to health care, not only of a person in the final hours
or days of their lives, but more broadly care of all those with a terminal condition that has
become advanced, progressive, and incurable
Death in the US - correct answer: chronic disease is leading cause (decline in death from HD and
cancer, increase in accidents/suicides/OD)
ppl are living longer with life-limiting illnesses, need to care for ppl for longer periods of time
women have longer life expectancy (increase r/t accidents/OD/suicide)
increase in healthcare interaction with death/dying in past few decades; policy is important
preferences at end of life - correct answer: most people prefer to die at home but only a portion
of people actually get to die at home
terminal illness vs life-limiting illness - correct answer: basically same thing, deals with
reimbursement
life-limiting is more of living with an illness that will definitively cause death
serious illness - correct answer: A health condition that carries a high risk of mortality and either
negatively impacts a person's daily function or quality of life, or excessively strains their
caregivers
,trajectories of EOL - correct answer: terminal illness - 5% (changed by recent innovations)
organ failure - 80% (decline r/t exacerbations, return to function but lower than baseline before
exacerbation)
frailty (long period of slow decline, AD/dementia, doesn't fit well into hospice care)
sudden death - < 10% (not common, pay attention to caregivers/family)
goals of EOL care - correct answer: Pain and symptom management
Clear decision-making
Preparation for death
Completion
Contribution to others
Affirming of the whole person
define hospice - correct answer: For patients with life expectancy < 6 months* (designated by
two providers); must certified as terminally ill
Replaces curative therapies**
Covered by Medicare Hospice Benefit - rate (Replaces Medicare A & B - time is state-dependent)
May be provided in any setting, primarily home
Focused on symptom management, patient and family goals; improving comfort/QOL
, Provided by an interdisciplinary team (both for profit and not for profit agencies may collab with
provider in nursing home/etc and provide specialty care or nursing home may have their own
team)
define palliative care - correct answer: Palliative care ... is specialized ... care for people living
with serious illnesses. It is focused on providing patients with relief from the symptoms and
stress of a serious illness—whatever the diagnosis. The goal is to improve quality of life for both
the patient and the family.
Palliative care is provided by a team of ...specialists who work with a patient's other [providers]
to provide an extra layer of support. Palliative care is appropriate at any age and at any stage in
a serious illness and can be provided together with curative treatment.
what does palliative care look like - correct answer: Designated chaplain, other team members
Specialized vs primary palliative care
Specialized - extra training
Primary - can be provided by any healthcare provider, no extra training, imp part of nursing care
Type depends on resources of where you are
typically in facility that is associated with palliative care
difference between hospice and palliative care - correct answer: Key differences:
Concurrent treatment
Who is eligible
Payment structure
palliative care allows for concurrent curative and life-prolonging measures; terminal/non-
terminal illnesses and can begin at any stage of disease
paying for hospice - correct answer: medicare hospice benefit
state medicaid
