Implementing and sustaining evidence-based practices in long-term care.

End-of-Life Care

Click on the titles to display the resource.

  • Show description [+]

    This guideline focuses on recommendations for adults, aged 18 years and older, who have reached the part of the illness trajectory that includes the last days and hours of life. This guideline will provide evidence- based recommendations for Registered Nurses and Registered Practical Nurses on best nursing practices for end-of-life care during the last days and hours.

    Registered Nurses’ Association of Ontario (2011). End-of-life care during the last days and hours. Toronto, ON: Author. Retrieved from https://rnao.ca/sites/rnao-ca/files/End-of-Life_Care_During_the_Last_Days_and_Hours_0.pdf

     

  • Show description [+]

    A tool to assist with comparing your organization’s current practice with evidence-based RNAO best practice recommendations.

    Registered Nurses Association of Ontario (2022)Gap Analysis-End-of-Life Care During Last Days and Hours. Toronto. ON

  • Show description [+]

    A tool to assist with comparing your organization’s current practice with evidence-based RNAO best practice recommendations.

    Registered Nurses Association of Ontario (2022)Gap Analysis- Palliative Approach to Care in the Last 12 Months of Life. Toronto. ON

  • Show description [+]

    This best practice guideline (BPG) provides evidence-based recommendations to nurses and the interprofessional health team who support adults experiencing the last 12 months of a progressive life-limiting illness, and their families and caregivers. 

    Registered Nurses’ Association of Ontario (2020). A Palliative Approach to Care in the Last 12 months of Life. Toronto, ON: Author.

    Retrieved from: https://rnao.ca/bpg/guidelines/palliative-approach-care-last-12-months-life

    © 2020 RNAO. All rights reserved

  • Show description [+]

    This Guide summarizes the main points of The Substitute Decisions Act. It should not be used as a substitute for the legislation, and it is not a substitute for legal advice. To make the legislation easier to understand, the Guide avoids legal terminology wherever possible.

    Canadian Hospice Palliative Care Association. (2004). A Guide to Substitute Decisions Act. Retrieved from http://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/pgtsda.pdf.


     

  • Show description [+]

    This model guides all activities related to hospice palliative care, and develop local standards of practice.  The model is built on an understanding of health, the illness and bereavement experiences, and the role hospice palliative care plays in relieving suffering and improving quality of life. 

    Canadian Hospice Palliative Care Association. (March 2002). A Model to Guide Hospice Palliative Care: Based on National Principles and Norms of Practice.  Ottawa, ON: Author.  Retrieved from https://www.chpca.ca/wp-content/uploads/2019/12/norms-of-practice-eng-web.pdf
     

    Copyright © 2002, Canadian Hospice Palliative Care Association. All Rights Reserved.

  • Show description [+]

    The Abbey Pain Scale is an instrument designed to assist in the assessment of pain in patients who are unable to clearly articulate their needs, for example, patients with dementia, cognition or communication issues. The scale does not differentiate between distress and pain, so measuring the effectiveness of pain-relieving interventions is essential.

    Abbey, J; De Bellis, A; Piller, N; Esterman, A; Giles, L; Parker, D and Lowcay, B. Funded by the JH & JD Gunn Medical Research Foundation 1998 – 2002. This document may be reproduced with this acknowledgment retained.

    Retrieved from: https://www1.health.gov.au/internet/publications/publishing.nsf/Content/triageqrg~triageqrg-pain~triageqrg-abbey

     

     

     

     

  • Show description [+]

    Learn how to participate in advance care planning process in Ontario. The Speak Up Ontario website provides in formation on Advance Care Planning as a process of thinking about and sharing your wishes for future health and personal care. It can help you tell others what would be important if you were ill and unable to communicate.

    Speak Up. (n.d.). homepage. Retrieved from https://www.speakupontario.ca/
  • Show description [+]

    This advanced planning framework is seen through a health lens recognizing and building on interaction with the legal and ethical framework across the country and professions. The new Framework builds on the 2012 National Framework with a focus partnerships, and promoting collaboration among different system levels: local, provincial/territorial and national.

    Canadian Hospice Palliative Care Association.  (2020). Advance Care Planning in Canada: A Pan-Canadian Framework. Retrieved from https://www.advancecareplanning.ca/news/2019-updated-national-framework-acp-now-released/

     

    © 2020 Advance Care Planning Canada. All rights Reserved.

    ACP in Canada is a national collaborative project led by CHPCA

  • Show description [+]

    Advance Care Planning, Goals of Care, and Treatment Decisions & Informed Consent- Frequently Asked Questions (FAQ)

    Copyright @ 2022 Canadian Palliative Care Network

  • Show description [+]

    The Bereavement Risk Assessment Tool, or BRAT, is a psychosocial assessment tool used by care teams to communicate personal, interpersonal and situational factors that may place a caregiver or family member at greater risk for a significantly negative bereavement experience.

  • Show description [+]

    Purpose of the BPI tool is to assess the severity of pain and the impact of pain on daily functions. The tool can be used for patients with pain from chronic diseases or conditions such as cancer, osteoarthritis and low back pain, or with pain from acute conditions such as postoperative pain.

    Assessment areas included are severity of pain, impact of pain on daily function, location of pain, pain medications and amount of pain relief in the past 24 hours or the past week.

    The BPI copyright is held by Dr Charles S. Cleeland (1991). The copyright applies to the BPI and all it's derivatives in any language.

    Retrieved from http://www.npcrc.org/files/news/briefpain_short.pdf 

  • Show description [+]

    The CANHELP caregiver questionnaire was designed to evaluate satisfaction with care for older patients with life threatening illnesses, and the family members. A straight forward satisfaction instrument that you can use t rate the quality of care at the programs or organization level.

    Reference: CARENET Canadian Researchers at the End of Life Network. (n.d.). CANHELP Tool.  Retrieved from www.thecarenet.ca/index.php?option=com_content&view=article&id=115&Itemid=57.

  • Show description [+]

    The CHPCA is the national voice for hospice palliative care in Canada. Advancing and advocating for quality end-of-life/hospice palliative care, its work includes public policy, public education and awareneness.  Website www.chpca.net.

  • Show description [+]

    A comprehensive, holistic assessment of individuals and their families at end-of-life.

    Reprinted with Permission from Canadian Hospice Palliative Care Association.  Registered Nurses' Association of Ontario.  (2011). Appendix K of End-of-Life Care During the Last Days and Hours. Toronto, ON: Author.  pp. 114-115. 

  • Show description [+]

    This link provides information and support for professionals on palliative and end-of-life care, loss and grief.  There is a list of clinical tools and useful resources to enhance palliative and end life care. Website www.virtualhospice.ca.

  • Show description [+]

    Goals of Care discussions help a person living with a life-limiting illness understand the serious nature of their illness. If the person is incapable, the discussions are with their substitute decision-maker. Goals of Care discussions also help healthcare providers to understand the patient’s values and goals for their care.

    https://www.cancercareontario.ca/en/guidelines-advice/treatment-modality/person-centred-care/goals-of-care-toolkit-oncology

    Cancer Care Ontario

  • Show description [+]

    This information fact sheet is developed as a supplement to the RNAO Nursing Best Practice Guideline document for nurses. The nursing best practice guideline End-of-life Care During the Last Days and Hours is available for public viewing and free to download at www.rnao.ca/bestpractices.

    Registered Nurses’ Association of Ontario. (2011).  Care In The Last Days And Hours Of Life.  Toronto, Canada: Author.  Retrieved from https://rnao.ca/sites/rnao-ca/files/Care_in_the_Last_Days_and_Hours_of_Life.pdf

  • Show description [+]

    Guide and Algorithm to guide assessment and management of cancer related anxiety.

    Cancer Care Ontario. (2013). Palliative Care Toolkit for Indigenous Communities. Retrieved from https://www.cancercareontario.ca/en/guidelines-advice/treatment-modality/palliative-care/toolkit-aboriginal-communities

     

  • Show description [+]

    Diseases such as chronic obstructive pulmonary disease or congestive heart failure run a more fluctuating course and result in death in a less predictable timeframe than diseases such as renal disease or dementia. Each exacerbation can lead to remission (and future exacerbation) or death; knowing which will occur on any given admission is extremely challenging. General indicators of poorer prognosis (life expectancy of only weeks to many weeks) include poor performance status, impaired nutritional status and a low albumin level.

    Registered Nurses’ Association of Ontario. (2011). Appendix E of End-of-Life Care During the Last Days and Hours. Toronto, Canada: Author. pp103-105 .

  • Show description [+]

    On Mar. 17, 2021, the federal government passed Bill C-7 to amend the Criminal Code to expand eligibility for Medical Assistance in Dying (MAID). 

    Retrieved from: https://www.cno.org/en/trending-topics/medical-assistance-in-dying/ 

    © 2022 College of Nurses of Ontario

  • Show description [+]

    Residents with severe dementia or other end stage diseases eat less as part of the natural progression of their disease. Research at end of life suggests that as residents eat and drink less they do not suffer from hunger or thirst. This session will focus on “Comfort Feeding Only” (CFO), when oral intake is not sufficient to sustain life, and if prolonging life with artificial hydration is not consistent with the residents' wishes (as expressed by the resident or their substitute decision maker (SDM)).

    This webinar is intended for long-term care leaders facilitating practice change and direct care staff that will benefit from understanding CFO process and the goal of the feedings to achieve comfort by employing the least invasive and potentially most satisfying way to provide nutrition. During this webinar, participants will:

    • Understand process followed to identify gap, develop policy and implementation of CFO
    • How to have a conversation with resident, family/SDM for comfort feeding only
    • Learn different implementation strategies to initiate CFO
    • Know strategies focusing on safe positioning and swallowing
    • Recognize symptoms such as dry mouth that can be alleviated with minimal oral intake and/or oral care

    Presented by Dr. Evelyn Williams and Jennifer Wong - Veteran's Centre Sunnybrook Health Sciences Centre in collaboration with Registered Nurses’ Association of Ontario (2017). Comfort Feeding Only(CFO): Managing Feeding at End-of-Life. RNAO You Tube. Retrieved from https://youtu.be/OB_HMSqKcao

  • Show description [+]

    The Alzheimer Society Canada website contains a number of resources on the unique needs of people with dementia at the end of their lives. Reference: Alzheimer Society Canada Dementia and End of Life Care.

    Retrieved from: https://alzheimer.ca/en/help-support/im-caring-person-living-dementia/end-life-care

  • Show description [+]

    The recommendations within this BPG focus on quality of life, emphasizing a holistic approach to care that incorporates the person’s individuality and preferences, and that recognizes the person and family as the unit of care. Figure 2 identifies complex issues persons and their families may face when receiving palliative care, which are categorized into eight equally important domains.

    https://bpgmobile.rnao.ca/sites/default/files/Figure%202%20Domains%20of%20Issues%20Associated%20with%20Illness%20and%20Bereavement.pdf 

     

  • Show description [+]

    Early Identification & Prognostic Guide for Clinicians by Mississauga Halton PCN - This Early Identification and Prognostic Indicator Guide aims to help family physicians, specialist physicians and nurse practitioners in earlier identification of those patients nearing the end of life who could benefit from a palliative care approach to care.

    Reference: Mississauga Halton Palliative Care Network. (2019). Early Identification and Prognostic Indicator Guide. Retrieved from Ontario Palliative Care Network.

     

  • Show description [+]

    The revised Edmonton Symptom Assessment System (ESAS-r) is available in multiple languages and is designed to assist in the assessment of 10 common symptoms: pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, anxiety, well-being and constipation. It conveys the individual’s description of the severity of a symptom based on a scale ranging from 0 to 10. 

    Registered Nurses’ Association of Ontario. (2011). Appendix F of End-of-Life Care During the Last Days and Hours. Toronto, Canada: Author. pp. 106-107. 

  • Show description [+]

    The brainXchange End of Life Care section contains presentation slides and resources on end of life care, including care related to persons in the final stages of dementia.

    Website: http://brainxchange.ca/Public/Resource-Centre-Topics-A-to-Z/End-of-Life-Care.aspx

    © 2016 brainXchange

  • Show description [+]

    This brochure prepared by Alzheimer's Association provides support in preparing for the end of life, especially when families must make choices.

    Reference: Retrieved from Alzheimer's Association http://www.alz.org/national/documents/brochure_endoflifedecisions.pdf

  • Show description [+]

    Improving End-of-Life Care in First Nations, The Way Forward Integration Initiative, Quality End-of-Life Care Coalition of Canada and Canadian Hospice Palliative Care Association partnered to develop advance care planning educational resources for people living in First Nations Communities.

    Speak Up. (n.d.) Retrieved from http://www.advancecareplanning.ca/community-organizations/download-the-speak-up-campaign-kit/first-nations-acp-resources.aspx

  • Show description [+]

    This scale's purpose is to determine how nurses feel about certain situations in which they are involved with patients. All statements concern nursing care given to the dying person and/or his/her family. Where there is a reference to a dying patient, assume it refers to a person who is considered to be terminally ill, with six months or fewer to live.

    Source: Folmelt, K. American Journal Hospice Palliative Care (Vol. 8, Issue 5) pp. 37-43 Copyright 1991 By Sage Publication

    Registered Nurses' Association of Ontario. (2011). Appendix G of End-of-Life Care During the last Days and Hours. Toronto, ON: Author pp. 108-109

    Retrieved from http://rnao.ca/sites/rnao-ca/files/End-of-Life_Care_During_the_Last_Days_and_Hours_0.pdf

  • Show description [+]

    This link takes you to the Geriatric Pain website http://www.geriatricpain.org

    The website was created to provide nurses who work in LTC environments with access to free best practice pain assessment tools and resources to help manage pain in older adults, including quality improvement processes focused on pain management

     

  • Show description [+]

    The Cancer Care website links to the guidelines for palliative care. The target population is any individual requiring palliative care. All Clinicians and staff involved in the delivery of palliative care can use this guideline.

    Retrieved from: https://www.cancercareontario.ca/guidelines-advice/types-of-cancer/28286

  • Show description [+]

    The Advocacy Centre for the Elderly (ACE) website provides various information related to health care consent and advance care planning, frequently asked questions and resources.

    https://www.acelaw.ca/legal-topic/health-care-consent-advance-care-planning/

    Copyright © 2024 The Advocacy Centre for the Elderly (ACE). All rights reserved.

  • Show description [+]

    The link will take you to the presentation by Judith Whal, hosted by Hospice Palliative Care Ontario https://hpco.adobeconnect.com/_a1122975890/p6js6fkeod3/?launcher=false&fcsContent=true&pbMode=normal

    The PDF version of the presentation is also attached. Retrieved from: http://www.hpco.ca/

  • Show description [+]

    This section of the brainXchange website focuses on health care consent and advance care planning, with many presentations and resources available to help when caring for persons at the end of life.

    Reference: Title: brainXchange, Health care consent and advance care planning (2016). This section of the brainXchange website focuses on health care consent and advance care planning, with many presentations and resources available to help when caring for persons at the end of life. Website: http://brainxchange.ca/capacity.aspx

  • Show description [+]

    This guide is intended to help health care/hospice palliative care professionals and volunteers to have a conversation with and/or respond to patients or their families around Medical Assistance in Dying (MAiD).

    Reference: Palliative Care and Medical Assistance in Dying (MAiD) in Canada (2017, June). Retrieved from https://www.chpca.ca/wp-content/uploads/2019/12/chpca-maid-booklet-eng-12page-final-web.pdf

  • Show description [+]

    The Hospice Palliative Care Ontario offers many educational resources for caregivers including Advance Care Planning and Health Care Consent for Health Service Providers. There is also a Palliative Care Core Course for Interdisciplinary staff which covers pain and symptom management, ethical decisions, communication and end of life in dementia. Materials are freely accessible.

    Reference: Title: Hospice Palliative Care Ontario (2015) Description: The Hospice Palliative Care Ontario offers many educational resources for caregivers including Advance Care Planning and Health Care Consent for Health Service Providers. There is also a Palliative Care Core Course for Interdisciplinary staff which covers pain and symptom management, ethical decisions, communication and end of life in dementia. Materials are freely accessible. Website: http://www.hpco.ca/

  • Show description [+]

    Implementing a Palliative Approach to Care in Long Term Care: An Implementation Guide and Resource Toolkit that aligns with the expanded Palliative Approach to Care requirements within the Fixing Long-Term Care Act, 2021 (FLTCA). The document is divided into 3 sections, each section starts with content related to the section’s theme, followed by a comprehensive list of resources, including hyperlinks. 
    1. Key concepts in a palliative approach to care
    2. Mentorship, education and support to build competency and capacity
    3. Implementing a palliative approach to care

    Retrieved from: https://www.palliativecareswo.ca/docs/LTCH_Resource_%20Guide.pdf  

  • Show description [+]

    Pallium Canada provides palliative care education to all health providers through workshops, e-learning and more.

    Website: http://pallium.ca/

  • Show description [+]

    Developed by a Canadian research team who has been funded by the Canadian Institutes for Health Research to explore the ethical, policy, and practice implications of Medical Assistance in Dying for Nurses. As part of our knowledge translation strategy, a Reflective Guide for Nurses that addresses six main areas of nursing practice in relation to Medical Assistance in Dying: nurses’ experiences, making moral sense, best practices, common dilemmas, and self-care. The Reflective Guide includes a video that provides a compelling insight into a few nurses’ experiences with Medical Assistance in Dying. This free guide can be used for individual study or as part of an educational offering.

    https://www.maidreflectiveguide.ca/

    Author: CIHR IRSC, Funding from CIHR: CIHR Project Grant PJT-148655; CIHR Project Grant PJT-169144

  • Show description [+]

    Medical assistance in dying (MAID) has been legal in Canada since 2016. Nurse practitioners, physicians, pharmacists, and “persons aiding practitioners” (including nurses) are permitted to help those who have explicitly requested MAID.
    Resources:

    • CNA Statement on the Passage of Bill C-14 (media release)
    • Code of Ethics for Registered Nurses
    • Palliative care and end-of-life resources

    © Copyright 2022 Canadian Nurses Association

  • Show description [+]

    On June 16, 2016, the federal government passed legislation to amend Canada’s Criminal Code and established a federal framework for Medical Assistance in Dying (MAID) for individuals who meet pre-defined eligibility criteria.

    MAID, as defined by the Government of Canada, refers to: The administering by a medical practitioner or nurse practitioner of a substance to a person, at their request, that causes their death. The prescribing or providing by a medical practitioner or nurse practitioner of a substance to a person, at their request so that they may self-administer the substance, and in doing so, cause their own death. As part of its efforts to implement a consistent approach to the MAID process in Ontario, the Ministry of Health and Long-Term Care (MOHLTC) has engaged the Centre for Effective Practice (CEP) to develop a resource to support clinicians (physicians and nurse practitioners) with the provision of MAID. Retrieved from: https://thewellhealth.ca/maid/

    Centre for Effective Practice. (2019). Medical Assistance in Dying (MAID): Ontario (rev). Retrieved from: https://thewellhealth.ca/maid/

     

  • Show description [+]
    This guide developed by the Ontario government is intended to provide information for those individuals who are considering Medical Assistance in Dying (MAiD). Web Address or Source: http://health.gov.on.ca/en/pro/programs/maid/docs/maid.pdf Reference: Medical Assistance in Dying – Information for Patients. (2017, May). Retrieved from http://health.gov.on.ca/en/pro/programs/maid/docs/maid.pdf
  • Show description [+]

    The Ministry of Health and Long-term Care (MOHLTC) has provided an update on medical assistance in dying (MAID) implementation pieces. This webpage is to provide the general public, patients and providers with MAID-specific information, guidance and resources.

    Retrieved from http://www.health.gov.on.ca/en/pro/programs/maid/default.aspx

  • Show description [+]

    The Ontario Palliative Care Network is a partnership of community stakeholders, health service providers and health systems planners who are developing a coordinated and standardized approach for delivering palliative care services in Ontario. In the website Resources section can be found many useful palliative care tools, guidance and evidence, reports and legislative updates.

    Web Address or Source:www.ontariopalliativecarenetwork.ca/

  • Show description [+]

    Ontario Regulation 246/22 was made under The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector April 11, 2022.

    Government of Ontario (2022) Ontario Regulation 246/22. Toronto ( ON) retrieved from O. Reg. 246/22: GENERAL (ontario.ca)

  • Show description [+]

    PACSLAC is a tool to observe and assess both common and subtle pain behaviours. Copyright © Shannon Fuchs-Lacelle and Thomas Hadjistavropoulos. The PACSLAC may not be reproduced without permission. For permission to reproduce the PACSLAC, please contact the copyright holders (Thomas.Hadjistavropoulos@uregina.ca).

    Retrieved from http://www.geriatricpain.org/content/Assessment/Impaired/Pages/default.aspx

  • Show description [+]

    This quality standard addresses palliative care for people who are living with a serious, life-limiting illness, and for their family and caregivers. The goal of palliative care is to relieve pain and suffering, and to improve a person’s quality of life. This quality standard focuses on care for people in all settings, including home and community, hospice, hospital, and long-term care.

    Health Quality Ontario (2018). Palliative Care Guide. Retrieved from: https://www.hqontario.ca/portals/0/documents/evidence/quality-standards/qs-palliative-care-clinical-guide-en.pdf

     

  • Show description [+]

    Cancer Care Ontario website links to best-practice tools from around the world to support primary care providers in the delivery of palliative care.  Tools are organized according to the 3-step model of best practice: Identify, Assess, and Plan.

    For resources tailored to support First Nations, Métis and Inuit families and communities, please see Tools for the Journey: Palliative Care in First Nations, Inuit and Métis Communities , a Resource Toolkit, developed by the Aboriginal Cancer Control Unit at Cancer Care Ontario.

    Retrieved from: https://www.cancercare.on.ca/toolbox/pallcaretools/

  • Show description [+]

    The Website contains numerous end-of-life resources for health care professionals.

    Copyright: End of Life Curriculum Project, a joint venture of the US Veterans Administration and SUMMIT, Stanford University Medical School

    Retrieved from http://palliative.stanford.edu/

  • Show description [+]

    Resource for palliative, pain and symptom management.

    Palliative Pain and Symptom Management Consultation Program: South Western Ontario.  (n.d.). Resources.  Retrieved on September 29, 2013.  Website www.palliativecareswo.ca.  © Copyright 2002-2008.

  • Show description [+]

    PPS may be used for several purposes. It is an excellent communicatiuon tool for quickly describing a patients current functional level.

    The Victoria Hospice Palliative Performance Scale (PPS, version 2) is an 11-point scale  communication tool for describing the current functional level and appears to have prognostic value.  The PPS provides a framework for measuring progressive decline over the course of illness.  If you wish to print any of these tools for your use, please go to https://victoriahospice.org/wp-content/uploads/2019/12/PPSv2-English-Sample.pdf to download a copy of Victoria Hospice's reprint and use permission request form.

    Victoria Hospice Society. (2001) Clinical Tools. Retrieved from hhttps://victoriahospice.org/wp-content/uploads/2019/12/PPSv2-English-Sample.pdf.

     © Victoria Hospice Society, 2006.

  • Show description [+]

    PPI relies on the assessment of performance status using PPS, oral intake, and the presence or absence of dyspnea, edema or delirium.

    Registered Nurses’ Association of Ontario. (2011). Appendix D of End-of-Life Care During the Last Days and Hours.  Toronto, Canada: Author. p 101.  Copyright (2008), with permission from Elsevier.

  • Show description [+]

    PaP uses the Karnofsky Performance Scale (KPS) and 5 other criteria to generate a numerical score from 0 to 17.5 to predict 30 day survival (higher scores predict shorter survival).

    Registered Nurses’ Association of Ontario. (2011).  Appendix D of End-of-Life Care During the Last Days and Hours. Toronto, Canada: Author. pp. 102-103.  Copyright (1999), with permission from Elsevier.

    Reprinted from Journal of Pain and Symptom Management, Vol. 17, No. 4, Maltoni, M, Nanni, O, Pirovano, M., Scarpi, E., Indelli, M, Martini, C, et al., Successful Validation of he Palliative Prognostic Score in Terminally ill Cancer Patient, 240-247

     

  • Show description [+]

    To facilitate sharing information about prognosis with the patient during end-of-life care discussions, clinicians can use the "SPIKES" process (Setting up, Perception, Invitation, Knowledge, Emotions, and Strategy and Summary).

    Registered Nurses’ Association of Ontario. (2011). SPIKES: A Six Step Strategy for Delivering Bad News (Baile et al., 2000, p. 305-307) of End-of-Life Care During the Last Days and Hours.Toronto, Canada: Author. p 30.

  • Show description [+]

    This tool is utilized when exploring the spiritual aspects of end-of-life.  ©1999 Christina Puchalski, M.D.

    Retrieved from  The George Washington Institute for Spirituality & Health https://smhs.gwu.edu/gwish/clinical/fica/spiritual-history-tool 

  • Show description [+]

    Individuals have a right t know their options and to have their preferences considered. Supporting individuals who are nearing the end of life requires interprofessional collaboration and problem-solving. Shared decision-maing can help individuals participate in the decision-making process in the ways the prefer and can help to meet their needs.

    Strategies for health-care providers to help families and individuals with decision making on end-of-care.

    Registered Nurses’ Association of Ontario (2011). Appendix J of End-of-Life Care During the Last Days and Hours. Toronto, ON: Author. pp. 112-113.

  • Show description [+]

    A palliative approach in long-term care (LTC) empowers families and staff to provide personalized and high-quality care for LTC residents living with chronic and life-limiting illnesses. This approach provides individuals with a seamless transition from chronic disease management to appropriate end-of-life planning and care. A palliative approach is beneficial at any stage in a chronic illness to maximize comfort and respect a person’s wishes.

    https://spaltc.ca/resource-library/?province=ontario

    Copyright © 2020 SPA LTC

  • Show description [+]

    Supportive and Palliative Care Indicator Tool SPICT™ helps clinicians identify people with one or more general indicators of poor or deteriorating health and clinical signs of life-limiting conditions for assessment and care planning.
    A single page tool that includes general (i.e. weight loss, hospital admissions, etc.) and broad specific disease indicators (i.e. breathlessness at rest for heart and respiratory disease). Also includes an assessment paradigm.

  • Show description [+]

    The National GSF Centre’s guidance for clinicians to support earlier identification of patients nearing the end of life leading to improved proactive person-centred care.  This updated 6th edition of the GSF PIG, renamed as Proactive Identification Guidance and formally known as Prognostic Indicator Guidance, aims to enable the earlier identification of people nearing the end of their life who may need additional supportive care. This includes people who are nearing the end of their life following the three main trajectories of illness for expected deaths – rapid predictable decline e.g. cancer, erratic decline e.g. organ failure and gradual decline e.g. frailty and dementia

    The Gold Star Framework. (2018). The Gold Standards Framework Proactive Identification Guidance (PIG). Retrieved from: https://www.goldstandardsframework.org.uk/cd-content/uploads/files/PIG/NEW%20PIG%20-%20%20%2020.1.17%20KT%20vs17.pdf

     

  • Show description [+]

    The Ontario Palliative Care Competency Framework A Reference Guide for Health Professionals and Volunteers - The Health Services Delivery Framework aims to provide guidance on how to optimize the current palliative care delivery model to ensure that the right care is provided by the right provider at the right time. This document focuses on adults with a progressive, life-limiting illness, who would benefit from palliative care along with the supports required for their families and caregivers. The document emphasizes the important role of education in building capacity for palliative care, as well as the need for providers to have the necessary competencies.

  • Show description [+]

    Ideas to conduct a conference with individuals and families to assist with decision making at end-of-life.

    Registered Nurses’ Association of Ontario (2011). Appendix H of End-of-Life Care During the Last Days and Hours. Toronto, ON: Author. pp. 109-110.

  • Show description [+]

    Tools to Support Early Identification for Palliative Care. The aim of this document is to support providers and system level leadership in earlier identification of patients who would benefit from palliative care.

  • Show description [+]

    This pamphlet is helpful in preparing families and caregivers for understanding the final stage of life.  

    Prepared by Ida Tigchelaar, RN, Palliative Care Pain & Symptom Management/Education Consultant, Oxford & Elgin Counties of Ontario.