Grainne McGettrick Policy and Research Manager Dementia Palliative Care: Context Setting/Background. PCA Conference 14 September 2012

Size: px
Start display at page:

Download "Grainne McGettrick Policy and Research Manager Dementia Palliative Care: Context Setting/Background. PCA Conference 14 September 2012"

Transcription

1 Grainne McGettrick Policy and Research Manager Dementia Palliative Care: Context Setting/Background PCA Conference 14 September 2012

2 Dementia Care in Ireland Lacking policy attention Underdeveloped services Limited investment People with dementia invisible and voiceless (42,000 people/50,000 carers) Dementia discourse

3

4 DPC Projects in Ireland Action research project CMHSOP Advanced care planning project, St. Vincent s Hospital, Athy Research project, The Alzheimer Society of Ireland

5

6

7 Aims of the Feasibility Study Building Consensus Signposting Work

8 The National Dementia Strategy 2013

9 DPC: The Challenges The nature of the disease/condition When does the PC approach start? What do we call this?

10 How you relate to us has a big impact...you restore our personhood, and give us a sense of being needed and valued. Give us reassurance, hugs, support, a meaning in life. Value us for what we can still do and be, and make sure we retain social networks. We're still here, in emotion and spirit, if only you could find us. Christine Bryden

11 Further information The Alzheimer Society of Ireland The Irish Hospice Foundations My journey into Dementia Palliative Care. Michele Hardiman RPN,RGN,Hdip,MA(Mgt) Clare Mental Health Service.

12 Tripping into dementia palliative care

13 A Journey of learning for everyone.

14 Sowing the seeds of reflective practice

15 Values and Beliefs What is important? What is the right thing to do? What do we have to do?

16 Psychological Needs (Kitwood) Attachment Hughes,J (2005) Palliative Care in Severe Dementia WHO definition of Palliative Care Support to Person and Family Aspects of PC Approach Importance of sensitive communication Comfort Symptom Control Quality of Life Identity Integration of psychological, social + spiritual aspects Whole Person Approach Occupation Affirmation of Life Respect for Autonomy Inclusion Support to Person & Family Care of Person & Family

17 Three ascending levels of specialisation: Level 1 Palliative Care Approach Informed by the principles of palliative care, aims to promote both physical and psychosocial well-being. A vital and integral part of all clinical practice, in hospitals or the community, whatever the illness or its stage Level 2 General Palliative Care Intermediate level practised by health care professionals with additional training and experience in palliative care. Level 3 Specialist Palliative Care (SPC) Core activity is palliative care by an inter-disciplinary team under the direction of a consultant in palliative medicine. Available in primary care, acute general hospitals and hospices (NACPC) (Palliative Care for All 20008)

18 Non-specialist palliative care has specific role in.. Symptom Management Personal Care dignity/privacy issues Physical Care - Nutrition Psychological Care Bereavement Care End of Life Care Prompt access to SPC as required

19 A potential Dementia Palliative Care Model Symptom Management Personal Care Physical Care Psychological Care Spiritual Care Bereavement End of Life Agitation Depression Confusion Anxiety Aggression Pain Medication Management Symptoms relating to Parkinson s Stroke Arthritis COPD Cancer Dignity Privacy Hygiene, Comfort, Safety Skin Integrity Nutrition Hydration Swallowing Elimination Sleep Mobility Activity Diagnosis Personal profile Choice Legal Security Autonomy Relationships Religion Culture Quality of Life Family support Education Care Plan SPC ACP

20 Rules and Regulations! & Ethical Dilemmas HIQA standards HACCP regulations Infection Control Policy Approved Centre Regulations (MHC)

21 Morals are messy. Ethics are everywhere. (Hughes,J.,Baldwin C. 2006) Moral theories give us ways of understanding what might be a good thing or what might be a bad thing. They provide a framework for ethical decisions we have to make.

22 Dilemmas I am caring for a person with dementia who has to have thickened fluids; this was ordered by the Speech and Language therapist as she is a high choking risk. She dislikes the thickened fluids so much she spits the drinks out. I went back to the SLT but she says the risks of choking are too high. It s hard to know what to do

23 Enabling a Palliative Care Approach Practice Development Examining our own Values and Beliefs Confidence in the tricky conversations Dealing with the Organisational issues

24 It is the small changes that eventually make a big difference to the persons life..i can now make changes at ward level". (Participant in Action Research)

25 Planning for the Future Dementia Specific Unit Project funded by Irish Hospice Foundation Cecelia Hayden CNS Dementia Muriel Parke CNS Palliative Care

26

27

28 I am not afraid to die But I don t want to be in pain

29 What are the advantages of end of life care discussions? Highlights the need to discuss end of life care and challenge perceptions about people with dementia Raises awareness for the need to recognise and document informal conversation or special moments with people with dementia Where there are a number of advanced medical problems, including dementia, a palliative approach to care is often more beneficial than invasive procedures Note discussions are around preferences and wishes are not a legal agreement.

30 STEP 1 Project team Discussion & Planning Overview of literature Case note reviews Staff Questionnaire Information sessions with staff

31 However! While nurses report finding it easy to initiate conversation around end of life with relative there was little documented evidence in care plans that any conversation took place!

32 STEP 2 Action Plan Developed recognising residents special moments Staff education Adapting Residents care plan Update local end of life policy End of life module on national dementia training programme Final Journeys Training Symptom Management guidelines End of Life Domain Three monthly review option Visual prompt cards

33 Care Plan Page The healthcare team can work with the person with dementia from initial meeting to introduce the need to discuss their preferences and wishes around end of life care Opportunity to discuss care options and alleviate decision making concerns. Worded in a way that encourages discussion about end of life care Provides means to document both formal and informal discussions around end of life care

34 It is really important to us that we care for you in the way that you want to be cared for. We want to make sure that any decisions about your end of life care or treatment both now and in the future are based on your values, wishes and preferences. We want you to remain as well as possible for as long as possible but have you ever thought about what would be most important to you if you became seriously ill while you are in St Vincent s?.. If the doctor and staff felt that acute treatment in a general hospital would not be of benefit to you at that particular time, what would you prefer to do? Remain in St Vincent s hospital for treatment and symptom management. Yes No Transfer for more advanced acute medical treatment to Accident and Emergency department. Yes No ALL DECISIONS ABOUT YOUR ONGOING MEDICAL CARE WILL BE MADE IN CONSULTATION WITH YOU AND YOUR DOCTOR, AND IN YOUR BEST INTEREST. You might find this conversation difficult, in which case could I ask you to think about your wishes and preferences around future end of life care and I will come back to you again on.. Nurse s Signature... Date.. Are there any documents we should be aware of in relation to your end of life care e.g. Enduring Power of Attorney (EPA)/ Ward of Court?... Ensure relevant information is documented and updated in residents medical notes

35 Can you tell me what you understand about your illness and this particular stage of it?.. What do you think would be most important to you when you are nearing end of life? Eg; Have you ever thought of where you would like to be? Who would you like to have with you?. Would you like to talk about any worries or fears that you may have about death and dying?..... Any preferences/wishes for after death?.... Wish to be Cremated: Yes No Have you shared any of this information with your family, friend or any other person? Yes No With. Relationship... Would you like to share this information with your other relatives? Yes No We would like to talk with you every three months to make sure we continue to know what your values, wishes and preferences are around your end of life care We may speak to you sooner if there is any change in your condition Information obtained from... Relationship.. Care Plan Commenced: No Yes Date.. Palliative Care Plan: No Yes Date...

36 Visual Prompt

37 Visual Prompt

38 Symptom Management Develop guidelines for staff to ensure symptoms at end stage dementia are addressed effectively, thereby optimising quality of life for people with dementia as they enter the dying phase of their illness Encourages nursing and medical staff to anticipate symptoms that may occur at end of life and prescribe accordingly

39 Symptom Management Guidelines on management and dosing in symptoms likely to occur nearing end of life Symptoms covered include Pain, nausea and vomiting, fever, excess secretions, convulsions, restless and agitation. GP/ Medical Officer/ Palliative Care advice to be sought when needed

40 Medication Form Dose Indications/Disadvantages Paracetamol Suppositories / PO Tablets / Dispersible500mg (max 1g per dose) Max 4g per 24 hours 1st line PO, PR administration in patients with dementia may be misinterpreted as assault causing distress and/or resistance. Diclofenac/ NSAID PO/ suppositories 25mg,50mg, 100mg Max 150mg per 24 hour in divided doses 1st line PO, PR administration in patient with dementia may be misinterpreted as assault causing distress and/or resistance. Caution if renal impairment or peptic ulcer disease. However even if a patient has renal impairment, if the patient is imminently dying and does not have opioid responsive pain, a NSAID may be required for quality of life. Consider PPI Oramorph PO solution 1.25mg 2.5mg Starting dose/4hrly PRN Side effects nausea, vomiting, constipation, opioid toxicity. May need to start regular anti-emetic. Suggest PRN antiemetic Oxycodone (Oxynorm) PO solution/ tablet Starting dose 1 2mg in opioid naive 1.5 times stronger than morphone sulphate. Similar side effects including opioid toxicity, constipation, nausea and vomiting

41 Visual prompt cards Enhance some patients involvement in decisions around end of life care, as far as they want and are able Maximises the potential for people with dementia to express their wishes and preferences around end of life care Used in conjunction with End of Life care plan page

42 Evaluation 100% of residents notes have relevant information on End of life domain Majority of staff had taken responsibility for writing in End of Life Domain, Two staff who had not initiated end of life discussion or written in care notes had not completed any training around end of life care Discrepancies between residents care plans and medical notes could lead to uncertainty in emergency situations

43 Next Step Address inconsistencies between nursing records and medical records Review transfer letter when people with dementia are transferred home or to another care area so that their preferences and wishes for end of life care are communicated to others Evaluate effectiveness of symptom management guidelines and prompt cards

44 Conclusion Staff need education to build confidence and communication skills to initiate end of life discussions as this can be challenging Improved documentation will improve quality of care for residents around end of life and reduce unnecessary invasive procedures and transfers On going process to ensure end of life care discussions occur

Understanding late stage dementia Understanding dementia

Understanding late stage dementia Understanding dementia Understanding late stage dementia About this factsheet This factsheet is for relatives of people diagnosed with dementia. It provides information about what to expect as dementia progresses to late stage.

More information

The Pharmacological Management of Cancer Pain in Adults. Clinical Audit Tool

The Pharmacological Management of Cancer Pain in Adults. Clinical Audit Tool The Pharmacological Management of Cancer Pain in Adults Clinical Audit Tool 2015 This clinical audit tool accompanies the Pharmacological Management of Cancer Pain in Adults NCEC National Clinical Guideline

More information

Release: 1. HLTEN515B Implement and monitor nursing care for older clients

Release: 1. HLTEN515B Implement and monitor nursing care for older clients Release: 1 HLTEN515B Implement and monitor nursing care for older clients HLTEN515B Implement and monitor nursing care for older clients Modification History Not Applicable Unit Descriptor Descriptor This

More information

Palliative Care Needs Assessment Guidance

Palliative Care Needs Assessment Guidance Palliative Care Needs Assessment Guidance National Clinical Programme for Palliative Care, Clinical Strategy and Programmes Division The Palliative Care Needs Assessment Guidance was prepared by the National

More information

Cancer Pain. Relief from PALLIATIVE CARE

Cancer Pain. Relief from PALLIATIVE CARE PALLIATIVE CARE Relief from Cancer Pain National Clinical Programme for Palliative Care For more information on the National Clinical Programme for Palliative Care, go to www.hse.ie/palliativecareprogramme

More information

Priorities of Care for the Dying Person Duties and Responsibilities of Health and Care Staff with prompts for practice

Priorities of Care for the Dying Person Duties and Responsibilities of Health and Care Staff with prompts for practice Priorities of Care for the Dying Person Duties and Responsibilities of Health and Care Staff with prompts for practice Published June 2014 by the Leadership Alliance for the Care of Dying People 1 About

More information

Good end of life care in care homes

Good end of life care in care homes My Home Life Research Briefing No.6 This briefing sets out the key findings of a research review on good end of life care in care homes undertaken by Caroline Nicholson, in 2006, as part of the My Home

More information

Opioids in Palliative Care- Patient Information Manual

Opioids in Palliative Care- Patient Information Manual Version 2.0 with MST example Introduction The following pages explain what opioids are and what we think you may want to know about them. There is quite a lot of information here, most of it is based on

More information

P: Palliative Care. Alberta Licensed Practical Nurses Competency Profile 155

P: Palliative Care. Alberta Licensed Practical Nurses Competency Profile 155 P: Palliative Care Alberta Licensed Practical Nurses Competency Profile 155 Competency: P-1 Assess Physiological Change P-1-1 P-1-2 P-1-3 P-1-4 P-1-5 Demonstrate knowledge of the physiological characteristics

More information

Submission to. Joint Committee on Health & Children. Public Hearings. End of Life Care in Community. November 5 th 2013

Submission to. Joint Committee on Health & Children. Public Hearings. End of Life Care in Community. November 5 th 2013 Submission to Joint Committee on Health & Children Public Hearings On End of Life Care in Community November 5 th 2013 Institute of Community Health Nursing Milltown Park, Sandford Road, Ranelagh, Dublin

More information

Care Guide: Cancer Distress Management

Care Guide: Cancer Distress Management Screening Tools for Measuring Distress Care Guide: Cancer Distress Management Instructions: Circle the number between [0 10] that best describes your patient s level of distress over the past week, including

More information

Service delivery interventions

Service delivery interventions Service delivery interventions S A S H A S H E P P E R D D E P A R T M E N T O F P U B L I C H E A L T H, U N I V E R S I T Y O F O X F O R D CO- C O O R D I N A T I N G E D I T O R C O C H R A N E E P

More information

Holy Cross Palliative Care Program. Barb Supanich,RSM,MD Medical Director June 19,2007

Holy Cross Palliative Care Program. Barb Supanich,RSM,MD Medical Director June 19,2007 Holy Cross Palliative Care Program Barb Supanich,RSM,MD Medical Director June 19,2007 Goals Define Palliative Care Scope of Palliative Care Palliative Care Services at Holy Cross Hospital Definition of

More information

The Lightbulb Moment Eureka!! Presented by: CNS Mary Corcoran CNM Avril Finnerty

The Lightbulb Moment Eureka!! Presented by: CNS Mary Corcoran CNM Avril Finnerty The Lightbulb Moment Eureka!! Presented by: CNS Mary Corcoran CNM Avril Finnerty Presenters Mary Corcoran CNS & RNP with Laois/Offaly Specialist Palliative Care Service Avril Finnerty CNM with Oakdale

More information

Finding Meaning and Purpose in Palliative Care

Finding Meaning and Purpose in Palliative Care Finding Meaning and Purpose in PALLIATIVE CARE WHAT IS IT? Jeffrey Rubins, MD Director, Palliative Medicine Hennepin Health Services deriv. from pallium, to cloak How do you pronounce palliative? medical

More information

Palliative Nursing. An EssEntiAl REsouRcE for HospicE And palliative nurses

Palliative Nursing. An EssEntiAl REsouRcE for HospicE And palliative nurses Palliative Nursing An EssEntiAl REsouRcE for HospicE And palliative nurses American Nurses Association Silver Spring, Maryland 2014 American Nurses Association 8515 Georgia Avenue, Suite 400 Silver Spring,

More information

Lymphoma and palliative care services

Lymphoma and palliative care services Produced 2010 Next revision due 2012 Lymphoma and palliative care services Introduction Despite improvements in treatment, many people with lymphoma will not be cured. Death and dying are things that people

More information

Health Professionals who Support People Living with Dementia

Health Professionals who Support People Living with Dementia Clinical Access and Redesign Unit Health Professionals who Support People Living with Dementia (in alphabetical order) Health Professional Description Role in care of people with dementia Dieticians and

More information

Caring for the Dying Patient (CDP) Document

Caring for the Dying Patient (CDP) Document HCR320.1 April 2015 Page 1 of 18 The Care for the Dying Patient documentation has 5 core components: Page 1. Relatives / Carers Contact Information and healthcare professional s signatory information (C

More information

QUALITY ACCOUNT 2015-16

QUALITY ACCOUNT 2015-16 QUALITY ACCOUNT 2015-16 CONTENTS Part 1 Chief Executive s statement on quality... 3 Vision, purpose, values and strategic aims... 4 Part 2 Priorities for improvement and statement of assurance... 5 2.1

More information

Collaborative Care Plan for PAIN

Collaborative Care Plan for PAIN 1. Pain Assessment *Patient s own description of pain is the most reliable indicator for pain assessment. Pain intensity to be assessed using the ESAS (Edmonton Symptom Assessment Scale) Use 5 th Vital

More information

NHS Continuing Healthcare

NHS Continuing Healthcare NHS Continuing Healthcare Questionnaire In association with Questionnaire 1. Full name of patient 2. Home address (prior to transfer into care home if applicable) 3. Patient s Date of Birth 4. Patient

More information

Palliative Care The Relief You Need When You re Experiencing the Symptoms of Serious Illness

Palliative Care The Relief You Need When You re Experiencing the Symptoms of Serious Illness Palliative Care The Relief You Need When You re Experiencing the Symptoms of Serious Illness Dealing with the symptoms of any painful or serious illness is difficult. However, special care is available

More information

Frequently Asked Questions about Pediatric Hospice and Pediatric Palliative Care

Frequently Asked Questions about Pediatric Hospice and Pediatric Palliative Care Frequently Asked Questions about Pediatric Hospice and Pediatric Palliative Care Developed by the New Jersey Hospice and Palliative Care Organization Pediatric Council Items marked with an (H) discuss

More information

Competencies for entry to the register: Adult Nursing

Competencies for entry to the register: Adult Nursing for entry to the register: Adult Nursing Domain 1: Professional values All nurses must act first and foremost to care for and safeguard the public. They must practise autonomously and be responsible and

More information

Quality End of Life Care: A Team Approach

Quality End of Life Care: A Team Approach Quality End of Life Care: A Team Approach Presented by Dann Baker, MDiv Director Pastoral Care & Ethics, JPS Health Network; Adjunct Assistant Professor, UNTHSC-TCOM Janet Lieto, DO, FACOFP Assistant Professor

More information

The Last Hours of Living

The Last Hours of Living The Last Hours of Living Ian Anderson Continuing Education Program in End-of of-life Care The Last Hours of Living! Over 90% of us will die after long illness! Last hours can be some of most significant

More information

Survey to Doctors in England End of Life Care Report prepared for The National Audit Office

Survey to Doctors in England End of Life Care Report prepared for The National Audit Office Survey to Doctors in England End of Life Care Report prepared for The National Audit Office 1 2008, medeconnect Table of Contents 1 SUMMARY OF FINDINGS... 3 2 INTRODUCTION... 5 3 RESEARCH OBJECTIVES AND

More information

Partnering for Success. The Nursing Facility and Hospice Partnership to Provide End-of-Life Care To Nursing Facility Residents

Partnering for Success. The Nursing Facility and Hospice Partnership to Provide End-of-Life Care To Nursing Facility Residents Partnering for Success The Nursing Facility and Hospice Partnership to Provide End-of-Life Care To Nursing Facility Residents 1 What will I learn today? Attitudes towards death & dying Overview of hospice

More information

Patient derived follow-up data (PREMs, PROMs and Work) (to be collected at 3 months)

Patient derived follow-up data (PREMs, PROMs and Work) (to be collected at 3 months) 1 Date (day/month/year) 2 Rheumatology Centre ID (to be completed by clinician) 3 Patient ID (NHS number - to be completed by clinician) Patient derived follow-up data (PREMs, PROMs and Work) (to be collected

More information

TEST OF COMPETENCE PART 1 - NURSING TEST. Please do NOT book your online Test of Competence until you have studied and reviewed the following modules.

TEST OF COMPETENCE PART 1 - NURSING TEST. Please do NOT book your online Test of Competence until you have studied and reviewed the following modules. CBT STUDY GUIDE TEST OF COMPETENCE PART 1 - NURSING TEST Please do NOT book your online Test of Competence until you have studied and reviewed the following modules. This Guide is to be used in conjunction

More information

Why and how to have end-of-life discussions with your patients:

Why and how to have end-of-life discussions with your patients: Why and how to have end-of-life discussions with your patients: A guide with a suggested script and some basic questions to use The medical literature consistently shows that physicians can enhance end-of-life

More information

GUIDELINES ON THE MANAGEMENT OF PAIN DUE TO CANCER IN ADULTS

GUIDELINES ON THE MANAGEMENT OF PAIN DUE TO CANCER IN ADULTS GUIDELINES ON THE MANAGEMENT OF PAIN DUE TO CANCER IN ADULTS Bristol Palliative Care Collaborative Contact Numbers: Hospital Specialist Palliative Care Teams: Frenchay 0117 340 6692 Southmead 0117 323

More information

O: Gerontology Nursing

O: Gerontology Nursing O: Gerontology Nursing Alberta Licensed Practical Nurses Competency Profile 145 Competency: O-1 Aging Process and Health Problems O-1-1 O-1-2 O-1-3 O-1-4 O-1-5 O-1-6 Demonstrate knowledge of effects of

More information

Lewy body dementia Referral for a Diagnosis

Lewy body dementia Referral for a Diagnosis THE Lewy Body society The more people who know, the fewer people who suffer Lewy body dementia Referral for a Diagnosis Lewy Body Dementias REFERRAL FOR A DIAGNOSIS In the UK people with all forms of dementia

More information

NMC Standards of Competence required by all Nurses to work in the UK

NMC Standards of Competence required by all Nurses to work in the UK NMC Standards of Competence required by all Nurses to work in the UK NMC Standards of Competence Required by all Nurses to work in the UK The Nursing and Midwifery Council (NMC) is the nursing and midwifery

More information

PALLIATIVE CARE SERVICES AND RESOURCES. A guide for patients and their loved ones. Living well with serious illness

PALLIATIVE CARE SERVICES AND RESOURCES. A guide for patients and their loved ones. Living well with serious illness PALLIATIVE CARE SERVICES AND RESOURCES A guide for patients and their loved ones Living well with serious illness A patient and family centered approach to living with serious illness Palliative care addresses

More information

PALLIATIVE CARE AGS. THE AMERICAN GERIATRICS SOCIETY Geriatrics Health Professionals. Leading change. Improving care for older adults.

PALLIATIVE CARE AGS. THE AMERICAN GERIATRICS SOCIETY Geriatrics Health Professionals. Leading change. Improving care for older adults. PALLIATIVE CARE AGS THE AMERICAN GERIATRICS SOCIETY Geriatrics Health Professionals. Leading change. Improving care for older adults. Why do we need palliative care? 1900 HOW AMERICANS DIED IN THE PAST

More information

The Care Certificate Standards

The Care Certificate Standards The Care Certificate Standards Copyright Health Education England, Skills for Care and Skills for Health 1 What is the Care Certificate? The Care Certificate is an identified set of standards that health

More information

Inquiry into palliative care services and home and community care services in Queensland. Submission to the Health and Community Services Committee

Inquiry into palliative care services and home and community care services in Queensland. Submission to the Health and Community Services Committee Inquiry into palliative care services and home and community care services in Queensland Submission to the Health and Community Services Committee August, 2012 1 Introduction The Queensland Nurses Union

More information

Ambitions for Palliative and End of Life Care:

Ambitions for Palliative and End of Life Care: Ambitions for Palliative and End of Life Care: A national framework for local action 2015-2020 National Palliative and End of Life Care Partnership Association for Palliative Medicine; Association of Ambulance

More information

Palliative Medicine, Pain Management, and Hospice. Devon Neale, MD Assistant Professor Dept of Internal Medicine UNM School of Medicine

Palliative Medicine, Pain Management, and Hospice. Devon Neale, MD Assistant Professor Dept of Internal Medicine UNM School of Medicine Palliative Medicine, Pain Management, and Hospice Devon Neale, MD Assistant Professor Dept of Internal Medicine UNM School of Medicine Pall-i- What??? Objectives: Provide information about Palliative Medicine

More information

What is Palliative Care

What is Palliative Care What is Palliative Care Maine Quality Counts Portland Regional Forum Isabella N. Stumpf, DO Division Director, Palliative Medicine, Maine Medical Center Medical Director, Palliative Care, MaineHealth Disclosure

More information

Guidance for doctors. Treatment and care towards the end of life: good practice in decision making

Guidance for doctors. Treatment and care towards the end of life: good practice in decision making Guidance for doctors Treatment and care towards the end of life: good practice in decision making The duties of a doctor registered with the Patients must be able to trust doctors with their lives and

More information

Guidance on competencies for management of Cancer Pain in adults

Guidance on competencies for management of Cancer Pain in adults Guidance on competencies for management of Cancer Pain in adults Endorsed by: Contents Introduction A: Core competencies for practitioners in Pain Medicine B: Competencies for practitioners in Pain Medicine

More information

What is hospice care? Answering questions about hospice care

What is hospice care? Answering questions about hospice care What is hospice care? Answering questions about hospice care Introduction If you, or someone close to you, have a life-limiting or terminal illness, you may have questions about the care you can get and

More information

Strengthening of palliative care as a component of integrated treatment throughout the life course

Strengthening of palliative care as a component of integrated treatment throughout the life course EXECUTIVE BOARD EB134/28 134th session 20 December 2013 Provisional agenda item 9.4 Strengthening of palliative care as a component of integrated treatment throughout the life course Report by the Secretariat

More information

Macmillan Lung Cancer Clinical Nurse Specialist. Hospital Supportive & Specialist Palliative Care Team (HSSPCT)

Macmillan Lung Cancer Clinical Nurse Specialist. Hospital Supportive & Specialist Palliative Care Team (HSSPCT) Title Location Macmillan Lung Cancer Clinical Nurse Specialist Hospital Supportive & Specialist Palliative Care Team (HSSPCT) Grade 7 Reports to Responsible to HSSPCT Nursing Team Leader HSSPCT Nursing

More information

Palliative Care Certification Requirements

Palliative Care Certification Requirements Palliative Care Certification Requirements Provision of Care, Treatment, and Services PCPC.1 1 Patients know how to access and use the program s care, treatment, and services. 2 3 Patients and families

More information

MAKING CHOICES: Living with advanced kidney disease

MAKING CHOICES: Living with advanced kidney disease MAKING CHOICES: Living with advanced kidney disease A guide to Maximum Conservative Care for those considering alternatives to dialysis Is dialysis the right choice for me? For many patients with renal

More information

Hospice Isle of Man. Education Prospectus 2016. Leading the Way in Palliative Care

Hospice Isle of Man. Education Prospectus 2016. Leading the Way in Palliative Care Hospice Isle of Man Education Prospectus 2016 Leading the Way in Palliative Care Introduction The need for palliative and end of life care is changing, with increasing demands and complexity. Therefore

More information

Diabetes at the End of Life. Dr David Kerr MD Bournemouth Diabetes and Endocrine Centre www.b-dec.co.uk

Diabetes at the End of Life. Dr David Kerr MD Bournemouth Diabetes and Endocrine Centre www.b-dec.co.uk Diabetes at the End of Life Dr David Kerr MD Bournemouth Diabetes and Endocrine Centre www.b-dec.co.uk A good way to live longer is to move to the eastern part of the English county of Dorset and take

More information

let s talk about hospice palliative care first decisions respect quality end of life

let s talk about hospice palliative care first decisions respect quality end of life let s talk about hospice palliative care first decisions respect quality end of life let s talk about hospice palliative care first for more information on hospice palliative care, please visit www.chpca.net

More information

Hospice and Palliative Care: Help Throughout Life s Journey. John P. Langlois MD CarePartners Hospice and Palliative Care

Hospice and Palliative Care: Help Throughout Life s Journey. John P. Langlois MD CarePartners Hospice and Palliative Care Hospice and Palliative Care: Help Throughout Life s Journey John P. Langlois MD CarePartners Hospice and Palliative Care Goals Define Palliative Care and Hospice. Describe and clarify the differences and

More information

Hospice Care. To Make a No Obligation No Cost Referral Contact our Admissions office at: Phone: 541-512-5049 Fax: 888-611-8233

Hospice Care. To Make a No Obligation No Cost Referral Contact our Admissions office at: Phone: 541-512-5049 Fax: 888-611-8233 To Make a No Obligation No Cost Referral Contact our Admissions office at: Compliments of: Phone: 541-512-5049 Fax: 888-611-8233 Office Locations 29984 Ellensburg Ave. Gold Beach, OR 97444 541-247-7084

More information

Pain and symptom management in pleural mesothelioma

Pain and symptom management in pleural mesothelioma Pain and symptom management in pleural mesothelioma MARF October 2006 Helen Clayson Hospice of St Mary of Furness University of Sheffield Outline Background to the study Symptoms in mesothelioma What is

More information

Pharmaceutical care of people requiring palliative care Course activities

Pharmaceutical care of people requiring palliative care Course activities Pharmaceutical care of people requiring palliative care Course activities Case Study 1 Mrs Green, a 70 year-old lady, has metastatic carcinoma of the breast (breast cancer with spread to other areas).

More information

Delirium. The signs of delirium are managed by treating the underlying cause of the medical condition causing the delirium.

Delirium. The signs of delirium are managed by treating the underlying cause of the medical condition causing the delirium. Delirium Introduction Delirium is a complex symptom where a person becomes confused and shows significant changes in behavior and mental state. Signs of delirium include problems with attention and awareness,

More information

Engaging Spirituality in Social Work for Palliative Care and Hospice

Engaging Spirituality in Social Work for Palliative Care and Hospice Engaging Spirituality in Social Work for Palliative Care and Hospice Conversations about Comfort, Support, and Quality of Life written by Palliative Care Consulting Team and Hwi-Ja Canda Lawrence Memorial

More information

RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND

RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND Monitor patient on the ward to detect trends in vital signs and to manage accordingly To recognise deteriorating trends and request relevant medical/out

More information

Release: 1. HLTEN511B Provide nursing care for clients requiring palliative care

Release: 1. HLTEN511B Provide nursing care for clients requiring palliative care Release: 1 HLTEN511B Provide nursing care for clients requiring palliative care HLTEN511B Provide nursing care for clients requiring palliative care Modification History Not Applicable Unit Descriptor

More information

PLANNING FUTURE CARE. Wishes & Preferences for My Future Care. This Plan belongs to:

PLANNING FUTURE CARE. Wishes & Preferences for My Future Care. This Plan belongs to: PLANNING FUTURE CARE Wishes & Preferences for My Future Care This Plan belongs to: Planning Your Future Care What is this Plan for? This Care Plan is your opportunity to think ahead and write down what

More information

Ward Manager, Day Care Sister and Clinical Services

Ward Manager, Day Care Sister and Clinical Services JOB DESCRIPTION Job Title : Line Manager: Responsible to: Manager Department : Staff Nurse (Day Care) Day Care Sister Ward Manager, Day Care Sister and Clinical Services Day Care Unit Probationary Period

More information

Making Your Wishes Known for End-of-Life Care

Making Your Wishes Known for End-of-Life Care Making Your Wishes Known for End-of-Life Care It may be difficult to imagine being too ill to make your own healthcare decisions. Unfortunately, that time may come. Something happens a critical injury,

More information

Pain Management after Surgery Patient Information Booklet

Pain Management after Surgery Patient Information Booklet Pain Management after Surgery Patient Information Booklet PATS 509-15-05 Your Health Care Be Involved Be involved in your healthcare. Speak up if you have questions or concerns about your care. Tell a

More information

HOW WOULD I KNOW? WHAT CAN I DO?

HOW WOULD I KNOW? WHAT CAN I DO? HOW WOULD I KNOW? WHAT CAN I DO? How to help someone with dementia who is in pain or distress Help! 1 Unusual behaviour may be a sign of pain or distress If you are giving care or support to somebody with

More information

Oxford University Hospitals. NHS Trust. Oxford Centre for Head and Neck Oncology. Pain Relief. Information for patients

Oxford University Hospitals. NHS Trust. Oxford Centre for Head and Neck Oncology. Pain Relief. Information for patients Oxford University Hospitals NHS Trust Oxford Centre for Head and Neck Oncology Pain Relief Information for patients Introduction This booklet has been written to give you information about pain relief.

More information

When Stopping Dialysis Treatment Is Your Choice. A Guide for Patients and Their Families

When Stopping Dialysis Treatment Is Your Choice. A Guide for Patients and Their Families When Stopping Dialysis Treatment Is Your Choice A Guide for Patients and Their Families National Kidney Foundation s Kidney Disease Outcomes Quality Initiative (NKF-KDOQI ) The National Kidney Foundation

More information

Doncaster Community Health Team for Learning Disabilities. Information for families and carers. RDaSH. Learning Disability Services

Doncaster Community Health Team for Learning Disabilities. Information for families and carers. RDaSH. Learning Disability Services Doncaster Community Health Team for Learning Disabilities. Information for families and carers RDaSH Learning Disability Services Useful contact numbers General enquiries: 01302 796467 Duty nurse number:

More information

Planning Ahead. A guide for patients and their carers

Planning Ahead. A guide for patients and their carers Planning Ahead A guide for patients and their carers Somerset Health Community January 2015 Planning ahead Content Page Introduction 3 Key references and useful websites 4 Section 1 Preferred priorities

More information

Heartland Hospice Care

Heartland Hospice Care Heartland Hospice Care Enriching life. We enrich lives right at home. At Heartland, we proudly provide hospice care wherever you call home: the house you ve lived in for decades, a skilled nursing center,

More information

MONTANA Advance Directive Planning for Important Health Care Decisions

MONTANA Advance Directive Planning for Important Health Care Decisions MONTANA Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of

More information

Palliative Care for Children. Support for the Whole Family When Your Child Is Living with a Serious Illness

Palliative Care for Children. Support for the Whole Family When Your Child Is Living with a Serious Illness Palliative Care for Children Support for the Whole Family When Your Child Is Living with a Serious Illness Palliative care provides comfort and support to your child and family. When a child is seriously

More information

Hospice of the Western Reserve. Hospice and Palliative Care. Services for Serious, Chronic and Terminal Illnesses

Hospice of the Western Reserve. Hospice and Palliative Care. Services for Serious, Chronic and Terminal Illnesses Hospice of the Western Reserve Hospice and Palliative Care Services for Serious, Chronic and Terminal Illnesses A Tradition of Caring The leader in the community, Hospice of the Western Reserve is also

More information

Nursing excellence for underserved population in Romania. Hospice Casa Sperantei, Romania

Nursing excellence for underserved population in Romania. Hospice Casa Sperantei, Romania Nursing excellence for underserved population in Romania Hospice Casa Sperantei, Romania Organization Background Community awareness Prevention of suffering Care is always possible Organization Background

More information

Schizophrenia. This factsheet provides a basic description of schizophrenia, its symptoms and the treatments and support options available.

Schizophrenia. This factsheet provides a basic description of schizophrenia, its symptoms and the treatments and support options available. This factsheet provides a basic description of schizophrenia, its symptoms and the treatments and support options available. What is schizophrenia? Schizophrenia is a commonly misunderstood condition,

More information

August Is Palliative Care and Cancer Pain Awareness Month

August Is Palliative Care and Cancer Pain Awareness Month August Is Palliative Care and Cancer Pain Awareness Month What Is Palliative Care? Palliative care is a growing research area that focuses on improving the quality of life of all people living with cancer,

More information

HOSPICE ORIENTATION FOR SKILLED NURSING FACILITIES

HOSPICE ORIENTATION FOR SKILLED NURSING FACILITIES HOSPICE ORIENTATION FOR SKILLED NURSING FACILITIES (2008 Medicare Conditions of Participation for Hospice Care 418.122 (f)) Hospice Philosophy Hospice is a unique concept of care designed to provide comfort

More information

Access to Palliative Care Bill [HL]

Access to Palliative Care Bill [HL] Access to Palliative Care Bill [HL] CONTENTS 1 Palliative care support 2 Duty to commission palliative care services 3 Education and training 4 Research 5 Care Quality Commission 6 Effect on other legal

More information

GSF Dementia Care Training Programme - End of Life Care qualifications mapping template

GSF Dementia Care Training Programme - End of Life Care qualifications mapping template GSF Dementia Care Training Programme - End of Life Care qualifications mapping template GSF Programme Learning outcome Content of session & activities Core Units Core Qualification Learning outcome Assessment

More information

What services are provided by JSSA Hospice? Our personalized services for patients and family members include:

What services are provided by JSSA Hospice? Our personalized services for patients and family members include: FAQ S ABOUT HOSPICE What is Hospice? Hospice is a specialized type of healthcare for patients and families who are faced with a terminal illness. A team of physicians, nurses, social workers, bereavement

More information

A Carer s Guide to Depression in People with a Learning Disability

A Carer s Guide to Depression in People with a Learning Disability A Carer s Guide to Depression in People with a Learning Disability Fife Clinical Psychology Department Lynebank Hospital Halbeath Road Dunfermline Fife KY11 4UW Tel: 01383 565 210 December 2009 This booklet

More information

Criteria For Referral

Criteria For Referral Criteria For Referral St Margaret of Scotland Hospice, founded by the Sisters of Charity in 1950, is at the heart of the Community providing wholeness of care for both body and Spirit. Philosophy St Joseph

More information

Welcome to Understanding Loss & Bereavement

Welcome to Understanding Loss & Bereavement Welcome to Understanding Loss & Bereavement There is a range of evidence (Stephen et al 2006) that the way those who have been bereaved experience the events around the time of death will influence the

More information

Key Terms. Chapter 38. Disability, p. 640. Rehabilitation, p. 640. Rehab (cont) p. 640. Rehab. (cont), p. 640

Key Terms. Chapter 38. Disability, p. 640. Rehabilitation, p. 640. Rehab (cont) p. 640. Rehab. (cont), p. 640 Key Terms Chapter 38 Rehabilitation & Restorative Care Activities of daily living (ADL s) Disability Rehabilitation Restorative aide Restorative nursing care Disability, p. 640 Is any loss, absent, or

More information

Assessment of depression in adults in primary care

Assessment of depression in adults in primary care Assessment of depression in adults in primary care Adapted from: Identification of Common Mental Disorders and Management of Depression in Primary care. New Zealand Guidelines Group 1 The questions and

More information

Author s job title Interim End of Life Care Service Lead Directorate Medicine Directorate

Author s job title Interim End of Life Care Service Lead Directorate Medicine Directorate Document Control Title End of Life Care (Adults) Policy Author Interim End of Life Care Service Lead Author s job title Interim End of Life Care Service Lead Directorate Medicine Directorate Department

More information

Lambeth and Southwark Action on Malnutrition Project (LAMP) Dr Liz Weekes Project Lead Guy s & St Thomas NHS Foundation Trust

Lambeth and Southwark Action on Malnutrition Project (LAMP) Dr Liz Weekes Project Lead Guy s & St Thomas NHS Foundation Trust Lambeth and Southwark Action on Malnutrition Project (LAMP) Dr Liz Weekes Project Lead Guy s & St Thomas NHS Foundation Trust Page 0 What is the problem? Page 1 3 million (5 % population) at risk of malnutrition

More information

Often, patients with cancer do not raise issues important to them with their doctors or nurses.

Often, patients with cancer do not raise issues important to them with their doctors or nurses. p.0 Name: Often, patients with cancer do not raise issues important to them with their doctors or nurses. These issues might include: Difficulty with relationships It may be about the relationships you

More information

Recognition and management of the end of life in stroke patients. Dr Victor Pace Consultant, St Christopher s Hospice London April 2010

Recognition and management of the end of life in stroke patients. Dr Victor Pace Consultant, St Christopher s Hospice London April 2010 Recognition and management of the end of life in stroke patients Dr Victor Pace Consultant, St Christopher s Hospice London April 2010 What we shall cover overview of stroke and dying LCP: advantages and

More information

How To Take A Strong Opioid Painkiller

How To Take A Strong Opioid Painkiller Using strong painkillers for cancer pain This information is an extract from the booklet Controlling cancer pain. You may find the full booklet helpful. We can send you a copy free see page 8. Contents

More information

C1, C2 Continuing the Conversation: What is CRITICAL in providing comfort care?

C1, C2 Continuing the Conversation: What is CRITICAL in providing comfort care? C1, C2 Continuing the Conversation: What is CRITICAL in providing comfort care? Lorelei Sawchuk, RN, MN, CHPCN(C) Nurse Practitioner & Supervisor Palliative Care Program Royal Alexandra Hospital Edmonton,

More information

Survey of Nurses. End of life care

Survey of Nurses. End of life care Survey of Nurses 28 End of life care HELPING THE NATION SPEND WISELY The National Audit Office scrutinises public spending on behalf of Parliament. The Comptroller and Auditor General, Tim Burr, is an

More information

Continuing Professional Development for Registered and Enrolled Nurses

Continuing Professional Development for Registered and Enrolled Nurses Continuing Professional Development for Registered and Enrolled Nurses Contents Introduction: Aged Care Learning Solutions CPD Solution 0-04 Learning Plans and Catalogue CPD Solution Resources Learning

More information

JOB DESCRIPTION Palliative Care Triage CNS

JOB DESCRIPTION Palliative Care Triage CNS JOB DESCRIPTION Palliative Care Triage CNS Reporting to: Employment Status: Community Service Manager 0.9 FTE Date Prepared: January 2016 POSITION PURPOSE The Palliative Care Triage CNS (TCNS) provides

More information

The Care Certificate Standards Self-Assessment Tool

The Care Certificate Standards Self-Assessment Tool The Care Certificate Standards Self-Assessment Tool Copyright Health Education England, Skills for Care and Skills for Health 1 What is the Care Certificate? The Care Certificate is an identified set of

More information

Weaning off your pain medicine

Weaning off your pain medicine Weaning off your pain medicine UHN Information for patients taking opioid pain medicines Read this booklet to learn about: why you need to wean off your pain medicine how to wean off slowly how to control

More information

Hospice and Palliative Medicine

Hospice and Palliative Medicine Hospice and Palliative Medicine Maintenance of Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills

More information

National end of life qualifications and Six Steps Programme. Core unit mapping tool for learning providers

National end of life qualifications and Six Steps Programme. Core unit mapping tool for learning providers National end of life qualifications and Six Steps Programme Core unit mapping tool for learning providers National end of life qualifications and Six Steps Programme - Core unit mapping tool for learning

More information

Donepezil (Aricept ), Galantamine (Reminyl XL ), Rivastigmine (Exelon ) and Memantine (Ebixa )

Donepezil (Aricept ), Galantamine (Reminyl XL ), Rivastigmine (Exelon ) and Memantine (Ebixa ) Donepezil (Aricept ), Galantamine (Reminyl XL ), Rivastigmine (Exelon ) and Memantine (Ebixa ) ESCA: For the treatment of Alzheimer s disease. SECONDARY CARE SECTION TO BE COMPLETED BY INITIATING DOCTOR

More information