Communication at EndofLife for Personal Support Workers in

“Communication at End-of-Life” for Personal Support Workers in Long-Term Care Module 1

GOAL FOR MODULE 1 BEST PRACTICE at the Bedside 1. Beliefs, Ideas, Biases, and Stored Knowledge 2. Concepts and Content 3. Integration 4. Application 2

WHAT IS HOSPICE PALLIATIVE CARE? • Review working definitions of: – Hospice Palliative Care (HPC) – End of Life (EOL) Care • Review the CHPCA Model to Guide Palliative Care. • Reflect on the Philosophy of Hospice Palliative Care and End of Life Care. • Discuss myths and misconceptions about care. 3

WHAT IS HOSPICE PALLIATIVE CARE? 1. Hospice Palliative Care means providing comfort when someone is actively dying. 2. Hospice Palliative Care starts when someone is close to dying and ends at death. 3. Hospice Palliative Care is for people dying with cancer. 4. Telling residents they are dying takes away their hopes. 5. Receiving Hospice Palliative Care means you will die sooner. 6. Hospice Palliative Care begins with a doctor’s order. 4

PERSONAL DEFINITIONS DYING DEATH DEAD LIVING Small Group Activity: On a post-it note, create a definition for each of these words. Share your definitions with others at your table, come to an agreement on a definition with your group, and post it on the wall. 5

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NOT JUST THE DYING! The philosophy and principles of Hospice Palliative Care may apply to patient populations other than the dying. Hospice Palliative Care programs may play a secondary role in addressing the needs of these groups. http: //www. chpca. net/norms 8

WHEN IS IT APPROPRIATE? Anyone living with or at risk of developing a life – threatening situation: – Due to any diagnosis – With any prognosis – Regardless of age – At any time that they have unmet expectations or needs and are prepared to accept care http: //www. chpca. net/norms 9

HOSPICE PALLIATIVE CARE… Aims to address: – Physical, psychological, social, spiritual, and practical expectations and needs – Loss, grief, and bereavement – Preparation for, and management of self– determined life closure and the dying process. Canadian Hospice Palliative Care Association (2013). A Model to Guide Hospice Palliative Care. Ottawa, ON: Canadian Hospice Palliative Care Association. Also available at: http: //www. chpca. net/media/319547/norms-of-practice-eng-web. pdf 10

HOSPICE PALLIATIVE CARE… Aims to address: – Suffering, a state of distress associated with events that threaten the intactness of a person and are accompanied by a perceived lack of options for coping. Cassell (1991) 11

HOSPICE PALLIATIVE CARE… Aims to address: – The quality of living and dying – sense of individual well being, experiences that are meaningful and valuable to the individual and their ability to have such experiences. 12

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MEET BETTY – DOMAIN GAME Our residents play with the cards they are dealt 15

DAILY CARE ACTIVITIES… What PSW activities would support a resident experiencing needs in the various domains of holistic care needs? 16

17 ASSESSMENT FOR THE PALLIATIVE CARE PHILOSOPHY • Would you be surprised if this resident died in the next 3 months? 6 months? • Have there been hospital admissions recently? • Are there distressing physical and psychological symptoms? • What are the goals of care? What is the resident’s/family’s understanding of the disease processes, prognosis, and treatment options? Quality Palliative Care in Long Term Care Alliance www. palliativealliance. ca

18 ASSESSMENT FOR THE PALLIATIVE CARE PHILOSOPHY • Are there significant social and spiritual concerns affecting daily life? • Has the resident and their family participated in advance care planning? • Has resuscitation been discussed recently? Quality Palliative Care in Long Term Care Alliance www. palliativealliance. ca

WHAT IS HOSPICE PALLIATIVE CARE? 1. Hospice Palliative Care means providing comfort when someone is actively dying. 2. Hospice Palliative Care starts when someone is close to dying and ends at death. 3. Hospice Palliative Care is for people dying with cancer. 4. Telling residents they are dying takes away their hopes. 5. Receiving Hospice Palliative Care means you will die sooner. 6. Hospice Palliative Care begins with a doctor’s order. 19

HOSPICE PALLIATIVE CARE IS: • NOT a person/resident/patient • NOT a place • NOT a program 20

HOSPICE PALLIATIVE CARE IS: • Provided to a person/resident/patient • Provided in a place • Provided by health care practitioners, program, service etc. 21

HOSPICE PALLIATIVE CARE IS: A philosophy of care People are not palliative! The CARE they would benefit from is PALLIATIVE! 22

23 PALLIATIVE CARE IS COMMITTED TO: “…healing, and that is something different from curing. Healing is to make a person whole, to relieve suffering and to give the individual a sense of who he or she is as a person. ” “Palliative care is person-centered, not disease-centered. ” Dr. Larry Librach