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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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.
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.
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
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.
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
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.
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.
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.
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.
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: https://gerocentral.org/wp-content/uploads/2013/12/Pain-Assessment-Checklist-for-Seniors-with-Limited-Ability-to-Communicate-PASLAC.pdf
