Download Improving Quality of Life for People who are Dying in Long Term

2015 BCCPA Annual Conference
Panel Presentation: “Revisiting End-of-Life in
Canada”
Pat Porterfield, RN, MSN
Funded by the Michael Smith Foundation for Health
Research | BC Nursing Research Initiative
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Resources for the Integration of Long Term Care
and Palliative Care
The following slides guide you to resources on this topic developed by
two research initiatives:
• iPANEL—Initiative for a Palliative Approach in Nursing:
Evidence and Leadership, a BC Nursing Research Initiative, Michael
Smith Foundation for Health Research
http://www.ipanel.ca
• Improving Quality of Life for People who are Dying in Long
Term Care Homes, a Community University Research Alliance funded
by the Social Sciences and Humanities Research Council (SSHRC) of
Canada. Developed the The Quality Palliative Care in Long-Term Care
Homes (QPC-LTC) Alliance to create LTC specific resources.
http://www.palliativealliance.ca
iPANEL publications on www.ipanel.ca
esp. relevant to residential care
• Integration of a Palliative Approach in Home, Acute Medical, and
Residential Care Settings: Findings from a Province-Wide Survey
iPANEL investigators have conducted a mixed-methods province-wide survey of registered
nurses (RNs), licensed practical nurses (LPNs) and health care workers in three settings:
acute medical units, residential care facilities and home care settings. Survey results provide
descriptive information relevant to implementing a palliative approach to better serve the
needs of people with advancing chronic life-limiting conditions
• Dying to Care: How can we provide sustainable quality care to
persons living with advanced life limiting illness in British Columbia?
The iPANEL advisory board report, Dying to care: How can we provide sustainable quality
care to persons living with advanced life limiting illness in British Columbia, was released in
June 2014 and contains key recommendations for action.
• A palliative approach to care of residents with dementia
An article describing an interprofessional pilot workshop for direct care providers which
aims to incorporate a palliative approach into dementia care for residents.
iPANEL Webinars related to a palliative approach
in residential care
– Integrating a Palliative Approach in Residential
Care: The Holy Family Extended Care Experiment
– The Knowledge Translation of a Palliative
Approach
– Integrating a Palliative Approach into Dementia
Care
– Integration of a palliative approach in hospital,
residential, and homecare nursing: Results of a
province-wide survey
And more…..check the iPANEL website and
newsletters….
A “snapshot” of the iPANEL Webinar: A
Knowledge Synthesis on a Palliative Approach

An understanding of a
palliative approach can
guide us in integrating
palliative care into
various settings including
residential care.
 Our synthesis resulted in
describing three themes
that are essential
features of a palliative
approach in all settings
of care:
Conceptual foundations of a palliative approach: a knowledge synthesis. Sawatzky, R., Porterfield, P. et al—Paper submitted for
publication . April 2015
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Improving Quality of Life for People who are Dying
in Long Term Care Homes (2009-2013)
The Quality Palliative Care in Long-Term Care Homes
(QPC-LTC) Alliance
Outcomes:
 Promoted LTC culture change in whole organization:
LTC Homes: Providing Care for Life
 Developed framework for developing inter-professional
palliative care programs specific to LTC including 40+
resources downloadable at no cost.
 Created partnerships between LTC homes, community
organizations and researchers to improve quality of life of
residents to the end of life.
 Promoted the role of the Personal Support Worker in
palliative care
Comprehensive Palliative Approach to Care in LTC:
Resident Journey from Admission to EoL
Time of Death
End of Life
Transition
Stable
Bereavement
PC brochure
Pre admission
ACP & PC education
Adapted from CHPCA Model of Care, 2013 by QPC-LTC www.palliativealliance.ca
Framework for Implementing Palliative Care in Long Term Care
Homes
www.palliativealliance.ca
Quality Palliati
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Improving Quality of Life for People who are
Dying in Long Term Care Homes (2009-2013)
Personal Support Worker Role
• PSWs provide the majority of the bedside care to residents at
the end-of-life in LTC, but their role and contribution in PC
was not clearly defined.
• A set of PSW competencies for palliative care in LTC were
created that outline their role and scope of practice to guide
interprofessional communication, and PSW inclusion in
decision-making:
– what is the PSW qualified to do?
– how is the PSW role distinct from /value added to the other
professional roles?
• PSW empowerment and inclusion in developing the palliative
care program is key to creating a sustainable culture
incorporating palliative care in LTC
• Educational opportunities promote PSW empowerment
Additional LTC Resources
www.palliativealliance.ca
10
New National Curriculum for
Palliative Care in Long Term Care
(LEAP LTC)
Website: www.pallium.ca
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LEAP LTC Modules
Proposed Time for module
Being Aware
Taking Ownership and Who is the Team
GI, Hydration and Nutrition
40 minutes
75 minutes
60 minutes
EOL Decision Making and Dilemmas
60 minutes
Advance Care Planning
60 minutes
Psychosocial Support
60 minutes
Essential Conversations
30 minutes
Delirium, Dementia and Depression
60 minutes
Pain I and II
120 minutes
Palliation of Dyspnea and Other Symptoms in Chronic Illnesses
90 minutes
Last Days and Hours
Working with Families
60 minutes
Grief and Suffering: What to Say and Do
45 minutes
The Challenge: Organizational Readiness
30 minutes
Learning Essential Approaches to Palliative care
for Long Term Care
LEAP LTC
• Now booking courses, various formats
available
• Seeking new facilitators for this curriculum
from across the country, including BC.
• Information is available on the Pallium
website: www.pallium.ca or by contacting
Natalie Gravelle-Ray at [email protected]