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

End-of-Life Care

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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Advance Care Planning in Canada: A Pan-Canadian Framework

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

Advance Care Planning in Canada: A Pan-Canadian Framework
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Strategies for Helping Individuals Engage in Decision Making at the End of Life - RNAO Appendix J

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.

PDF icon Strategies for Helping Individuals Engage in Decision Making at the End of Life

Canadian Hospice Palliative Care Association Square of Care and Organization - RNAO Appendix K

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. 

PDF icon Canadian Hospice Palliative Care Association Square of Care

Palliative Prognostic Score (PaP) - RNAO Appendix D

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

 

PDF icon Palliative Prognostic Score (PaP)

Palliative Performance Scale (PPS), Version 2 - RNAO Appendix D

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.

Palliative Performance Scale (PPS)
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Edmonton Symptom Assessment System (revised version) - ESAS-r - RNAO Appendix F

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. 

PDF icon ESAS-r from RNAO End-of-Life Care BPG

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