The following resource is designed to assist Long-Term Care (LTC) homes with the implementation of the End-of-Life Care During the Last Days and Hours Best Practice Guideline. Documents found in this resource are evidence-based, but it is not a program plan. Each LTC home is unique and each home is in various stages of guideline implementation. LTC homes are advised to use the resource at their discretion. For those resources that have copyright notations, it is recommended that LTC homes obtain permission from the primary author prior to implementing them within their setting. The Toolkit is a dynamic resource, and is being updated and revised on a regular basis by the LTC Best Practices Program team. Visit this site often to see what's new!
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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:
© Copyright 2022 Canadian Nurses Association
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
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.
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.
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.
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.
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)
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.
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 |
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
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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 |
