Authors:

Metzey, MD; Dubler, NN; Bottrell, M; Mitty, E; Ramsey, G; Post, LF; Hill, T.

Publisher:

New York Division of Nursing John A. Hartford Foundation Institute for Geriatric Nursing The MontefioreMedicalCenter Division of Bioethics

Date:

2001

How to obtain resource/guideline:

The John A. Hartford Foundation Institute for Geriatric Nursing at hartfordign@nyu.edu or 212-998-5355

Summary:

The guidelines are the result of a 4 part process: focus groups, a national expert panel review, qualitative analysis of reimbursement data and a survey of nursing facility administrators. They focus on 7 Principles important to the care of dying residents in nursing homes: Culture and Organization, Ongoing Communication to Staff, Supporting Resident and Family Decisions, Best Practices on Pain and Symptom Management; Hospitalization as a Last Resort, Federal and State Oversight, and Competency. Each Principle is outlined and recommendations are suggested with short notes from focus group participants.

Internet link:

hartfordign@nyu.edu

Authors:

Lo, K; Brandt, K; Meier, C; Egan, K; Pyron, M; Sunter, S; Threats, D; Crown, J; Johnston, C; Ladd,LA;

Publisher:

National Hospice and Palliative Care Organization

Date:

2001

How to obtain resource/guideline:

Tel. 703-837-1500 or 800-646-6460 Or, on line www.nhpco.org/marketplace click on marketplace>products then go to search: Hospice Care in Nursing Facilities: 2 items will appear #700345 is the guide on 2 CD ROMs, $89 Members; $129 non-members and #700330 which is the 2 volume guide plus the 2 CD ROMs, $119 Members; $189 non-members

Summary:

This educational resource guide in two volumes teaches and promotes the fundamental principles and benefits of providing hospice and palliative care in nursing homes using step by step Modules. Volume I explains the regulatory and documentation requirements of nursing homes with regard to palliative and hospice care. Volume II explains the fundamentals of hospice care and its philosophy. Each Module offers charts and tables as easy teaching tools. The topics include: Care in a Nursing facility, Plan of Care, MDS, Payment Systems, Quality Indicators, Resident Choice, Philosophy, Team Care, End Stage Disease, Spiritual Care, Pain Management, Care of the Actively Dying Patient, Grief and Bereavement.

Internet link:

www.nhpco.org/marketplace

Authors:

Hospice Organization and Palliative Experts (HOPE) of Wisconsin; Wisconsin Department of Health and Family Services (DHFS) Division of Supportive Living (DSL), Bureau of Quality Assurance (BQA); The Wisconsin Health Care Association; The Wisconsin Association of Homes and Services for the Aging

Publisher:

Jointly by the Authors

Date:

October 2001

How to obtain resource/guideline:

www.dhfs.state.wi.us/rl_DSL/Hospice/HospiceIntro.htm

Summary:

This document is designed to provide guidelines for Nursing Homes and Hospices when Nursing Home patients choose to use the services of Hospice. It guides the Hospice and Nursing Home through regulations, contracts, coordination of services, reimbursement, provisions for care, eligibility, responsibility, terms of agreement to more easily care for the patient, as well as, clinical protocols, individual agency services, physicians, quality assurance, care plans. It discusses issues such as, change in condition, the death event, bereavement, choices, emergency care. And, it has a section on training. As an update, this second edition, clarifies contracts, encourages consistency and promotes Hospice care in the Nursing Home setting.

Internet link:

www.dhfs.state.wi.us/rl_DSL/Hospice/HospiceIntro.htm

Authors:

Harrison J; BattlesW; Stebel J; Presley R; Jiang Q

Publisher:

Georgia Collaborative to Improve End of Life Care

Date:

2001

Other:

Georgia Collaborative: Georgia Coalition for Health Georgia Health Policy CenterGeorgia Health Decisions Georgia Medical Care Foundation

How to obtain resource/guideline:

GMCF 57 Executive Park South, NE;

Cost:

Free on line at www.gmcf.org click on publications then research projects

Summary:

This was a long term care research initiative to improve the quality of care for end-of life care in Georgia. Phase I : Examined Current Patterns of 21,990 residents in Georgia Nursing Homes showing very high death rates within first 90 days; Phase II: Planning and Delivery of End-of-Life Care examined 30 randomly selected resident charts from each of 20 facilities showing less than 12% with advanced care planning and discrepancies in EOL documents; Phase III: Education Initiative to include end-of- life planning as part of all care plan conferences and the POLST form which documents end-of- life preferences be updated and readily accessed. Documentation increased from 39.4%-69.2%. Recommended leadership and health care professional strategies are provided. Overall those using LTC initiatives showed positive change related to EOL issues.

Internet link:

www.gmcf.org

Authors:

Henderson, ML; Hanson, LC; Reynolds, KS

Publisher:

Springer Publishing Co.

Date:

2003

How to obtain resource/guideline:

Springer Publishing Co 536 Broadway New York, NY10012 or www.SpringerPub.com

Cost:

$36.95

Summary:

This manual is designed to aid nursing home, palliative care and hospice teams in educating staff in the care of frail and dying elders in nursing homes. It focuses on individualized plans of care with emphasis on final phases of life; grief and loss; advance care planning; eating and drinking choices; pain management; spiritual and emotional care and care and training of care givers. It uses case studies and exercises to encourage understanding, discussion and tool developing. An extensive reference list is also provided.

Internet link:

www.SpringerPub.com

Authors:

Ferris, FD; Balfour, HM; Bowen, K; Farley, J; Hardwick, M; Lamontagne, C; Lundy, M; Syme, A; West, PJ

Publisher:

Canadian Hospice Palliative Care Assoc.

Date:

2002

Other:

ISBN:1-896495-17-6

How to obtain resource/guideline:

CHPCA;

Cost:

Free by going to www.chpca.net, click on resources, under ordering click full version; or, 1 copy free to members; $20 for additional copies or for non members either CD ROM or soft print copy.

Summary:

This Model provides a guide for patient and family hospice palliative care using "norms" rather than "standards" of practice leading to a National Model. Selected topics are understanding health and illness; definitions, values and principles; effective communication and group function; the process of providing palliative care; the Square for Care Concept as a tool in processing the essential and basic steps during a therapeutic encounter and its Application in education, policy development, quality management, the care team and research; and the nature of Hospice and Palliative care organizations.

Internet link:

www.chpca.net norms@cpca.net

Authors:

National Hospice Organization Nursing Home Task Force

Publisher:

National Hospice Organization

Date:

April 13, 1998

How to obtain resource/guideline:

National Hospice & Palliative Care Organization

Summary:

This publication documents a series of challenges related to access/ partnerships for care and regulations designed to improve access of Hospice care in Nursing Homes. Each challenge is posed and then followed by recommendations for meeting the challenge. It asks questions regarding value and role; availability; payment types and managed care with several recommended solution paths. The appendices include information on the certification process; assessment forms (MDS; care plan) and intervention strategies.

Authors:

Commonwealth of Australia Department of Health and Aged Care

Publisher:

Publication Production (Public Affairs, Parliamentary and Access Branch) #4065

Date:

2000

Other:

ISBN 0 642 44733 0

How to obtain resource/guideline:

On line free at the Australian Government Department of Health and Ageing; The National Palliative Care Program www.palliativecare.gov.au/strategy.htm publication and resources>national Palliative Care Strategy> download

Summary:

The Strategy guides the development and implementation of palliative care policies, strategies and services insuring consistent and accessible quality palliative care to all people of Australia who are dying. It provides for community and professional understanding and awareness and fosters professional commitment to the care needs of the people near death and their families. It is committed to improving the quality and effectiveness of palliative care delivery by resource allocation and service development and promotes partnerships in the delivery of that care.

Internet link:

www.palliativecare.gov.au/strategy.htm

Authors:

Australian Department of Veteran’s Affairs

Publisher:

Australian Department of Veteran’s Affairs

Date:

July 2000

How to obtain resource/guideline:

Department of Veteran’s Affairs

Summary:

This manual provides links to pathways and forms. Palliative care guidelines are presented for specific topics, such as pain, dyspnea, anxiety, depression. A detailed listing of clinical pathway for palliative care including: outcome, diagnosis, health perception, assessment categories, treatment plan, case history and references.

Internet link:

http://www.dva.gov.au/health/provider/community_nursing /pathways/pallcare.pdf

Authors:

Department of Pain Medicine and Palliative Care, BethIsraelHospital

Publisher:

Department of Pain Management and Palliative Care, Beth Israel hospital

Date:

Dec 5, 2001

How to obtain resource/guideline:

www.StopPain.org PCAD online registration form or Myra Glajchen, DSW Institute for Education and Research in Pain and Palliative Care Department of Pain and Palliative Care Beth Israel medical Center First Avenue at 16th Street New York, NY 10003 Tel: 212-844-1472

Summary:

This manual was designed to guide the care team of imminently dying patients. The goals are to respect the patient’s wishes; minimize symptom distress; support families; eliminate unnecessary interventions and regulations; provide bereavement services; facilitate the transition to alternative care settings, such as, hospice. The Palliative care for Advanced Disease (PCAD) pathway consists of 3 components: Care Path; Daily Patient Care Flow Sheet; and Health Care Provider/MD-Order sheet. It details a 5 step PCAD "process for utilization" pathway with a flowchart for easy use, which addresses Identifying the dying patient; Team assessment; Clarification of treatment; Implementation; and Discharge.

Internet link:

www.StopPain.org mglajchen@bethisraelny.org

Authors:

F. Amos Bailey

Publisher:

Menasha Ridge Press

Date:

2003

Other:

Chapter 2.3 Nursing Home Care

How to obtain resource/guideline:

F. AmosBaileySafeHarbor Palliative Care Project Birmingham, VAMC University of Alabama, BirminghamBirmingham, Alabama35205

Summary:

This is an educational tool. Each chapter opens with Key Points for a 12-15 min discussion; contains detailed Handouts; Provider Pocket Cards; and Selected Readings. It covers an overview, Hospice in assisted Living, Educating Long Term Care Facilities in End of Life Care, Nutrition and Hydration.

Internet link:

http://www.hospice.va.gov/INDEX.HTM(click on "Promising Practices")

Authors:

Pelovitz, SA

Publisher:

Department of Health and Human Services Center for Medicare and Medicaid Services

Date:

10-May-02

Other:

Ref: S&C-02-29

How to obtain resource/guideline:

http://www.cms.hhs.gov/medicaid/survey-cert/letters.asp Search: Ref: S&C-02-29 SAP, Director: Survey and Certification Group Center for Medicaid and State Operations Dept of Health and Human Services 7500

Summary:

This communication from the Center for Medicare and Medicaid Services provides guidance as a "framework" in structuring collaborative relationships between Hospice and Nursing Homes when providing end-of-life care for in common residents and their families. The topics included are: Partnership Development; Care Practice Coordination; Specific services provided by Hospice and specific services provided by the Nursing Home

Internet link:

http://www.cms.hhs.gov/medicaid/survey-cert/letters.asp or mconnolly@cms.hhs.gov