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Starts at $9.98 per contact hour
Min. Hours $$/Hr
4 hours $8.98
8 hours $7.98
12 hours $6.98
20 hours $5.98
30 hours $4.98

End-of-Life Issues: Physiologic Changes at the End of Life

3.5 Contact Hours
Target Audience: Nurses, healthcare professionals, and interested individuals
Purpose/Goal: The outcome of this course is for the learner to describe the physiologic changes in body systems associated with the end of life, and identify ways to compassionately care for the individual experiencing these changes.
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For health care professionals to provide compassionate, quality care to patients at the end of life they must understand the many changes the patient undergoes. Holistic end-of-life care provides relief, comfort, and support whenever possible. It involves a comprehensive approach to the physical, emotional, psychological, and spiritual aspects of the individual. Guidelines for the care of specific physical symptoms at the end of life will also be presented.

Upon completion of the course, you will be able to do the following:

  • Describe major physiologic changes at the end of life related to the cardiovascular system.
  • Describe major physiologic changes at the end of life related to the gastrointestinal system.
  • Describe major physiologic changes at the end of life related to the nervous system.
  • Describe end-of-life changes in the respiratory system.
  • Describe end-of-life changes in the renal system.
  • Describe end-of-life changes associated with malignancies.
  • Explain the end-of-life changes that occur with HIV/AIDS.
  • Describe clinical care guidelines for specific conditions at the end of life, including ascites, cachexia, and anorexia.
  • Describe clinical care guidelines for the end-of-life conditions of constipation and diarrhea.
  • Describe clinical care guidelines for the end-of-life conditions of cough and fatigue.
  • Describe clinical care guidelines for the end-of-life conditions of nausea and vomiting.
  • Discuss the symptoms present in the final days and hours of life.

As an individual nears the end of his or her life, decisions about health care become more complex. Not only does physical care become important, but the patient’s emotional, social, spiritual, and psychological needs must also be addressed. Family and caregivers must be included in the overall management of the disease (Comfort, 2001). Communication is extremely important. For example, the intent of decisions made by the individual, family, and health care providers may be misunderstood and the consequences less certain (Kuebler, Berry, & Heidrich, 2002; National Institutes of Health [NIH], 2013a; Strada, 2013).

The physical changes experienced at the end of life become more challenging and the results of their assessment and treatment can “ripple” through the patient, family, and friends.

Most life-threatening illnesses have a familiar and documented natural clinical course, which provides patients and their families with a framework in which to make important quality-of-life decisions about care at the end of life. The trajectory of the disease provides the health care professional with valuable information about what patients have undergone, their emotional states (as well as the emotional state of the family), and their goals for care (Kuebler et al., 2002; McCarthy, Phillips, Zhong, Drews, & Lynn, 2000; NIH, 2013a).

However, preferences of the caregivers may not be the same as the patient’s preferences at the end of life. Some disagreed about controlling the time and place of death but patients and caregivers usually agreed about symptom and pain management (Comfort, 2001; NIH, 2013a).

Physiological changes at the end of life can vary widely, since individuals may be of any age, or they may be individuals who are dying from “natural causes” related to the normal process of aging.

Complete the course post exam (CE Test) with a score of 80% or greater. Complete all fields of the course evaluation form. Certificate of Completion is provided once the course post exam is passed per criteria above.

  • American Board of Managed Care Nursing
  • ANCC - American Nurses Credentialing Center
  • AOTA - American Occupational Therapy Association
  • ASWB - Association of Social Work Boards
  • California Board of Behavioral Sciences
  • California Board of Registered Nursing
  • California Department of Health, Aid, and Technician Certification Section
  • District of Columbia Board of Nursing
  • Florida Board of Nursing
  • Florida Board of Nursing - Certified Nursing Assistants
  • Florida Board of Respiratory Care
  • Florida Council of Dietetics and Nutrition
  • Florida Council of Licensed Midwifery
  • NAADAC - The National Association of Alcohol and Drug Abuse Counselors
  • NCBTMB -National Certification Board for Therapeutic Massage & Bodywork
  • Florida Board of Massage Therapists


Practice Level:


Content Focus:

Domain of OT

Course Expires:

May 30, 2019

  • Cyndie Koopsen, RN, BSN, MBA, HNB-BC, RN-BC, HWNC-BC
  • Caroline Young, MPH
Jurisdictional Requirements:

Continuing education (CE) licensing requirements vary by jurisdiction, are not well defined, and may change. These CE requirements may vary in terms of the number of hours required to the types of courses that must be taken. ALLEGRA Learning Solutions, LLC recommends you contact your licensing board or accrediting organization for the latest continuing education requirements of your state or territory. Compliance with CE requirements is the responsibility of the individual health care provider. Health care providers must understand the CE requirements in their jurisdictions, and be sure they are up-to-date on any rule changes that affect their license. For further information, please see our Accreditation Information.

Accommodations for Disabilities:

Every effort will be made to accommodate your special needs. To request accommodations, please contact us.

Conflicts of Interest and Relevant Financial Relationships:

The authors/planning committee members have no conflicts of interests or relevant financial relationships to declare relevant to this activity.

Commercial Support:

No commercial support has been received for this activity.

Non-endorsement of products:

Accreditation refers to recognition of continuing nursing education only and does not imply ALLEGRA Learning Solutions, LLC approval or endorsement of any commercial product.

Off-label Use of Products:

None of the authors intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.