A Palliative Approach in Residential Care Settings (March 2014)
-
Upload
joan-trinh-pham -
Category
Health & Medicine
-
view
2.240 -
download
0
description
Transcript of A Palliative Approach in Residential Care Settings (March 2014)
![Page 1: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/1.jpg)
Providence Health CareProvidence Health Care
A Palliative Approach in Residential Care Settings
Joan Pham RN, BScN, CHPCN (c)Palliative Outreach & Consult Team - Residential Care
March 2014
Bear by Coast Salish artist Andy Peterson, Skokomish Nation
![Page 2: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/2.jpg)
Providence Health CareProvidence Health Care
Overview• What is Palliative Care
– Visual: Palliative Care + Treatment Across Time– Terminology:
• Palliative Care vs. End of Life Care vs. Terminal Care
• Specialized Palliative Care vs. A Palliative Approach to Care– Settings– Disease Trajectory
• Frail Elders– Eden Principles + Palliative Approach– Who is living in Residential Care?– Ambiguous Dying– Visual: Palliative Approach + Treatment Across Time in Residential Care
Settings• Goals of Care Conversations• Resource: iPal app
![Page 3: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/3.jpg)
Providence Health CareProvidence Health Care
What is Palliative Care?
![Page 4: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/4.jpg)
Providence Health CareProvidence Health Care
What is Palliative Care?• An approach that improves the quality of life• For patients and their families• Facing the problem associated with life-
threatening illness• Works to identify + relieve suffering:
Pain and symptom management• Psycho social and spiritual care• Medical treatment and disease management• Preparing and managing for dying• Bereavement
(World Health Organization)
![Page 5: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/5.jpg)
Providence Health CareProvidence Health Care
Visualizing Palliative Care in Treatment Across Time
• Murray S, Kendall M, Boyd K and Sheikh A. Illness trajectories and palliative care. BMJ 2005 4; 330; 1007-1011 doi:10.1136/bmj.330.7498.1007 (adapted from Lynn and Adamson 2003).
• Adapted from Lynn and Adamson, 2003. 5 With permission from RAND Corporation, Santa Monica, California, USA.
![Page 6: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/6.jpg)
Providence Health CareProvidence Health Care
![Page 7: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/7.jpg)
Providence Health CareProvidence Health Care
![Page 8: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/8.jpg)
Providence Health CareProvidence Health Care
Considering Settings:Specialized Palliative Care vs. A Palliative Approach
![Page 9: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/9.jpg)
Providence Health CareProvidence Health Care
![Page 10: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/10.jpg)
Providence Health CareProvidence Health Care
Frail EldersWho do you see on your units?Who is living in residential care?
![Page 11: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/11.jpg)
Providence Health CareProvidence Health Care
Eden Alternative: 10 Principles of Care
Taken from http://edenalt.co.za/wp-content/uploads/2013/01/Eden-SA-Poster2.png
![Page 12: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/12.jpg)
Providence Health CareProvidence Health Care
Who is living in residential care:• 48% of all residential clients who were admitted
and died during (FY 09/10 – 10/11) died within 90 days of admission
• At BFH and HFH, 65% and 62% of residential clients died within 90 days of admission
(Decision Support, Providence Health – July 2011 Report)
![Page 13: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/13.jpg)
Providence Health Care
The
Ambiguous Dying Syndrome
The ambiguous dying syndrome. Bern-Klug M. Health Soc Work. 2004 Feb;29 (1):55-65.
![Page 14: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/14.jpg)
Providence Health CareProvidence Health Care
We are living longer. By 2025: • 30% of the population > 65. • 33% increase in deaths over 2004.• 2/3 will die with 2 or more chronic diseases after months or years in
state of “vulnerable frailty”.• Only 20% of us will die with a recognizable terminal (“palliative”)
phase.
The Senate of Canada. (2010). Raising the Bar: A Roadmap for the Future of Palliative Care in Canada. Available at: http://secure.cihi.ca/cihiweb/products/end_of_life_report_aug07_e.pdf
![Page 15: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/15.jpg)
Providence Health CareProvidence Health Care
![Page 16: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/16.jpg)
Providence Health CareProvidence Health Care
Visualizing Palliative Care in Treatment Across Time:In Residential Care Settings
![Page 17: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/17.jpg)
Providence Health CareProvidence Health Care
A Palliative = Goals of CareApproach to Care Conversations
![Page 18: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/18.jpg)
Providence Health CareProvidence Health Care
A Palliative Approach to Care =
![Page 19: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/19.jpg)
Providence Health Care
A Palliative = Goals of CareApproach to Care Conversations
• Formal / Informal• Documented• Timely• Continuous + progressive across residential + acute care settings
![Page 20: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/20.jpg)
Providence Health CareProvidence Health Care
Goals of Care Conversation Tips• Record conversations
– Formal / Informal– Details
• Expect to repeat yourself• Meet residents + families where they are at• Strengthen impact of conversations
– Provide educational materials– Follow-up conversations– Build on relationships
• Continuity– Acute + Residential Care settings– Record of conversations
![Page 21: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/21.jpg)
Providence Health CareProvidence Health Care
![Page 22: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/22.jpg)
Providence Health CareProvidence Health Care
![Page 23: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/23.jpg)
Providence Health CareProvidence Health Care
![Page 24: A Palliative Approach in Residential Care Settings (March 2014)](https://reader036.fdocuments.us/reader036/viewer/2022081400/554b7045b4c90551118b5240/html5/thumbnails/24.jpg)
Providence Health CareProvidence Health Care
Thank You!Holy Family Hospital Extended Care Unit
Staff + Family
PHC Palliative Care ProgramPHC POCT Residential Care Team
Tilly Schalkwyk RN, MSN, CNSElder Care Program, PHC Residential Care
iPanel + InspireNetAlliance for Quality Palliative Care in Long-Term Care
The Way ForwardNational Framework Initiative for Hospice Palliative Care Integration