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Institute of Gerontology

Wayne State University
Institute of Gerontology
87 East Ferry Street
226 Knapp Building
Detroit, Michigan 48202

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End-of-Life Care

Long Term Care Intensive Train-the-Trainer Series
Training Module Request Form

The End-of-Life Care training modules were designed to summarize key concepts and are intended for individual use by long term care and hospice professionals only to train staff and family members on end-of-life issues. They are not exhaustive or comprehensive and should be used with due diligence and an understanding of the target audience. The professionals who use them should always adhere to professional standards, apply concepts only if fully understood, and seek clarification from the Wayne State University Institute of Gerontology or Hospice of Michigan if any clarification is deemed necessary.

Please fill out the form below to request the End-of-Life Care training modules that you would like to receive. Incomplete forms cannot be accepted. Please be sure to enter a valid e-mail address for an account that can receive e-mail attachments.

Name (Title, First, Middle Initial, Last):

E-mail Address:

Which of the following modules would you like to receive?
(Check all that apply)

Historical Perspectives of Dying and Death in America          Communication Skills at End-of-Life
Ethical and Legal Concerns          Imminent Death
Pain Management          Grief, Loss, and Bereavement

Please check the type of agency in which these training modules will be used:
(Check all that apply)

Nursing Home          Health Professional Group
Senior Center          Academic Institution
Assisted Living Facility          Support Groups/Families
General Hospital          Psychiatric Hospital
Government Agency          Other - please specify:

Location of Agency (City, State/Province, Country):

How many people do you expect to attend the training program?:

Will there be a fee charged to attend?: No        Yes

(Optional) Fee range:

Submission of your request may take a moment...please wait for confirmation.

For more information about the end-of-life training modules, or to suggest additions to the end-of-life resources page, please e-mail Dr. Jennifer Mendez at jmendez@med.wayne.edu.