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Palliative Care

The BC Renal Agency, working with kidney care professionals from across the province, aims to support the delivery of high-quality care for people with kidney disease in the last years, months or days of their lives, regardless of where they live in BC.

Guidelines & Tools


The framework report is aligned with the BC Renal Agency's strategic priority of creating quality outcomes and better value for patients. 


Key principles of the framework include close collaboration with palliative care colleagues and programs in the geographic Health Authorities, as well as alignment with the Ministry of Health Services palliative care strategy.

As outlined in the framework report there are four distinct aspects needed for full renal EOL program development. These are:

  • patient identification
  • symptom assessment and management
  • advance care planning process
  • care in the final stages, including grief and bereavement.
 

Medical assistance in dying (MAiD) became legal in Canada on June 17, 2016, when the Government of Canada passed Bill C-14, which established the legal framework to regulate this ‎health care service. 


In British Columbia, common systems, forms and tools were developed to support health care providers in addressing MAiD inquiries and requests from patients, families and the general public.


The BC Ministry of Health website provides comprehensive information on MAiD for health care providers and the public. All provincial MAiD forms are also available on the website.


E-learning courses on MAiD specially designed for Registered Nurses and Assessors and Prescribers are available on PHSA's LearningHub.


Each health authority has also established a MAiD Care Coordination Service, Centre or Office. Professional colleges in BC too have online resources dedicated to MAiD. 


Health care providers working within health authorities should contact their HA’s designated coordinator for MAiD, or their supervisor for more information on policy and processes.

Health authority links:




Resources

Fraser Health
fraserhealth.ca: Information on Advance Care Planning & Hospice Palliative Care Symptom Guidelines

Vancouver Coastal Health
vch.ca: In the search box type in "advance care planning", "palliative care", "end of life care", or "advance directive" for a variety of options.

Providence Health Care
http://hpc.providencehealthcare.org/: Information on palliative and hospice care.

Vancouver Island Health
viha.ca: VIHA Advance Directives.
victoriahospice.org: Victoria Hospice's Palliative Care Education. Includes Bereavement Risk Assessment Tool and Palliative Performance Scale.

Interior Health 
www.interiorhealth.ca/YourCare/PalliativeCare/: A repository of information on palliative care, including advance care planning.

Northern Health
http://bit.ly/2dY4w13: Information on end-of-life/palliative and hospice care.
https://northernhealth.ca/YourHealth/AdvanceCarePlanning.aspx: Information on advance care planning and related topics.

BC Children's Hospital
bcchildrens.ca: To view a variety of pamphlets on Grief and Palliative Care that includes symptom management, see the online A - Z pamphlets section of the Family Resource Library.
Canuck Place Children's Hospice: offers a variety of child and family support resources.
 
‎BC programs

British Columbia Hospice Palliative Care Association (BCHPCA) lists upcoming palliative care conferences and possible learning opportunities.
hospicebc.org


Canadian programs

Canadian Association of Nephrology Social Workers (CANSW).
cansw.org

Conservative treatment: Choosing not to start dialysis.
kidney.ca

Canadian Network of Palliative Care for Children.
cnpcc.ca

Canadian Society of Palliative Care Physicians (CSPCP) offers educational opportunities for physicians.
cspcp.ca

Canadian Virtual Hospice lists both healthcare professional educational opportunities and a variety of useful tools for practice.
virtualhospice.ca

Educating Future Physicians in Palliative and End-of-Life Care (EFPPEC) offers a variety of resources in the Palliative Learning Commons. This initiative is in collaboration with the Pallium Project and the CHPCA.
peolc-sp.ca


Ian Anderson continuing Education Program in End-of-Life Care University of Toronto. Note: As of May 1, 2007, this program is no longer offered; however, the materials remain accessible on the website below.
cme.utoronto.ca

Kidney Foundation of Canada
Under Services then Publications you will find two information pamphlets titled: Choosing to stop dialysis: A brochure for patients and families.
kidney.ca


TAPE Educational Services (in affiliation with the Continuing Education Division of St Michael's College in the University of Toronto) offers Skills Development Workshops and Online Programs.
adv-edu.com

The Association of Faculty of Medicine of Canada (AFMC) was funded by Health Canada to put together Curriculum Materials for Facilitating Advance Care Planning: An Interprofessional Education Program.
afmc.ca


International programs

American Association of Colleges of Nurses offers a program titled End-of-Life Nursing Education Consortium (ELNEC) that focuses on training nurses in EOL and palliative care.
aacn.nche.edu


American Nephrology Nurses' Association (ANNA) offers a series of three End-of-Life modules for CNE opportunities.
annanurse.org


Education in Palliative and End-of-Life Care (EPEC) Project from Northwestern University.
epec.net


End-of-life/Palliative Care Education Resource Center offers numerous resources. Be sure to check out the Fast Facts Index as a useful resource.
www.capc.org


EndLink: Resources for End-of-Life Care Education
endoflife.northwestern.edu

Harvard Medical School Center for Palliative Care
hms.harvard.edu

Hospice UK offers the following resource
learning.hospiceuk.org


National Kidney Foundation
kidney.org


Promoting Excellence in End-of-Life Care offers a tremendous list of resources including pediatrics.
promotingexcellence.org

Respecting Choices: An Advanced Care Planning program by a department of the Gundersen Lutheran Medical Foundation. This website lists both onsite and online ACP courses.
respectingchoices.org


National Association of Social Workers
socialworkers.org

'The Social Work End of Life Care Education Project: An assessment of educational needs' article from the National Association of Social Workers
socialworkers.org

The Social Work in Hospice and Palliative Care Network
swhpn.org (2009)‎

 
Patient identification 
Advance care planning
Symptom assessment & management
Patient outcomes scale symptom module
Care of dying & bereavement
 
 
BC reports
  • A provincial framework for End-of-Life Care published in May 2006 by G. Abbott. health.gov.bc.ca
  • Discussion paper on a Provincial Strategy for end-of-life care in British Columbia pub-lished in October 2002.health.gov.bc.ca
  • The Patients Property Act. qp.gov.bc.ca
  • The Health Care (Consent) and Care Facility (Admission) Act.qp.gov.bc.ca
  • The Representation Agreement Act. qp.gov.bc.ca
  • The Adult Guardianship and Planning Statutes Amendment Act, 2007. leg.bc.ca
  • The BC Ministry of Health has published document on end-of-life planning: 

Canadian reports
International reports
  • Australian Government: Department of Health and Ageing. The National Palliative Care Strategy - A National Framework for Palliative Care Service Development – October 2000. health.gov.au

  • Last Acts Committee. (2002, November). Means to a better end: A report on dying in America today. Washington, DC: Last Acts.
  • Mid-Atlantic Renal Coalition. (no date). Recommendations for addressing EOL in ESRD. Midlothian, VA.
  • Moss, A. (Ed.). (2003, March). Completing the continuum of Nephrology care end-stage renal disease peer workgroup: Recommendations to the Field (Promoting Excellence in End of Life Care). The Robert Wood Johnson Foundation.
  • National Association of Social Workers (NASW). NASW Standards for Social Work Practive in Palliative and End of Life Care.
    socialworkers.org
  • National Health Services (NHS) Department of Health (DH). The National Service Framework for Renal Services.
    dh.gov.uk
  • National Health Services (NHS) End-of-Life Care Programme. The Gold Standards Framework: A Programme for Community Palliative Care.
    goldstandardsframework.nhs.uk
  • National Health Services (NHS) National End of Life Care Programme / The University of Nottingham.
  • National LCP Renal Steering Group. (June 2008). Liverpool care pathway for the dying patient: Guidelines for LCP drug prescribing in advanced chronic kidney disease. Liverpool, UK: Marie Curie Palliative Care Institute
  • Program of Experience in the Palliative Approach (PEPA).
    pepaeducation.com
  • Promoting Excellence in End-of-Life Care offers a section on Palliative Care Tools Listed by Grantee (Demonstration Project) and National Workgroup.
    promotingexcellence.org
  • Renal supportive and end-of-life care: a one day workshop organized by the Department of Health on Monday, April 14th, 2008.
    dh.gov.uk
  • Stanton, P., & Noda, B. (2008, April). Renal end of life care action planning: Thematic analysis of outcomes from a DH stakeholder event held at Prospero House on 14th April, 2008. PowerPoint presented at the Renal supportive and end of life care: A one-day workshop.
  • The Royal Australian College of General Practitioners (RACGP) Advance Care Planning guidelines with links to a few more articles.
    racgp.org.au
  • The UK’s National Health Services (NHS) Department of Health (DH) published a document on 16 July, 2008, outlining England’s end-of-life care strategy: End of Life Care Strategy – promoting high quality care for all adults at the end of life.
  • The Marie Curie Palliative Care Institute of Liverpool provides several resources.
 
 

These are some professional organizations' position statements and standards of practice:

 
Resources


American Association of Colleges of Nurses offers a program titled End-of-Life Nursing Education Consortium (ELNEC) that focuses on training nurses in EOL and palliative care.
aacn.nche.edu 


American Nephrology Nurses' Association (ANNA) offers a series of three End-of-Life modules for CNE opportunities.
annanurse.org


British Columbia Hospice Palliative Care Association (BCHPCA) lists upcoming palliative care conferences and possible learning opportunities.
hospicebc.org


Canadian Association of Nephrology Social Workers (CANSW).
cansw.org


Conservative treatment: Choosing not to start dialysis.
kidney.ca


Canadian Network of Palliative Care for Children.
cnpcc.ca


Canadian Society of Palliative Care Physicians (CSPCP) offers educational opportunities for physicians.
cspcp.ca


Canadian Virtual Hospice lists both healthcare professional educational opportunities and a variety of useful tools for practice.
virtualhospice.ca


Educating Future Physicians in Palliative and End-of-Life Care (EFPPEC) offers a variety of resources in the Palliative Learning Commons. This initiative is in collaboration with the Pallium Project and the CHPCA.
peolc-sp.ca


Education in Palliative and End-of-Life Care (EPEC) Project from Northwestern University.
epec.net


End-of-life/Palliative Care Education Resource Center offers numerous resources. Be sure to check out the Fast Facts Index as a useful resource.
www.capc.org


EndLink: Resources for End-of-Life Care Education
endoflife.northwestern.edu


Harvard Medical School Center for Palliative Care

hms.harvard.edu


Hospice UK offers the following resource
learning.hospiceuk.org


Ian Anderson continuing Education Program in End-of-Life Care University of Toronto. Note: As of May 1, 2007, this program is no longer offered; however, the materials remain accessible on the website below.
cme.utoronto.ca


Kidney Foundation of Canada

Under Services then Publications you will find two information pamphlets titled: Choosing to stop dialysis: A brochure for patients and families.
kidney.ca


National Kidney Foundation
kidney.org


Promoting Excellence in End-of-Life Care offers a tremendous list of resources including pediatrics.
promotingexcellence.org


Respecting Choices: An Advanced Care Planning program by a department of the Gundersen Lutheran Medical Foundation. This website lists both onsite and online ACP courses.
respectingchoices.org


TAPE Educational Services (in affiliation with the Continuing Education Division of St Michael’s College in the University of Toronto) offers Skills Development Workshops and Online Programs.
adv-edu.com


The Association of Faculty of Medicine of Canada (AFMC) was funded by Health Canada to put together Curriculum Materials for Facilitating Advance Care Planning: An Interprofessional Education Program.
afmc.ca


National Association of Social Workers
socialworkers.org


'The Social Work End of Life Care Education Project: An assessment of educational needs' article from the National Association of Social Workers
socialworkers.org


The Social Work in Hospice and Palliative Care Network
swhpn.org (2009)

 

Fraser Health Authority

fraserhealth.ca: Information on Advance Care Planning & Hospice Palliative Care Symptom Guidelines

Vancouver Coastal Health

vch.ca: In the search box type in "advance care planning", "palliative care", "end of life care", or "advance directive" for a variety of options.

Vancouver Island Health

viha.ca: VIHA Advance Directives
victoriahospice.org: Victoria Hospice's Palliative Care Education. Includes Bereavement Risk Assessment Tool and Palliative Performance Scale.

BC Children's Hospital

bcchildrens.ca: To view a variety of pamphlets on Grief and Palliative Care that includes symptom management, see the online A - Z pamphlets section of the Family Resource Library.
Canuck Place Children's Hospice: offers a variety of child and family support resources.
 

Patient identification 

Advance care planning

Symptom assessment & management

Patient outcomes scale symptom module

Care of dying & bereavement

 
 

BC reports

  • A provincial framework for End-of-Life Care published in May 2006 by G. Abbott. health.gov.bc.ca
  • Discussion paper on a Provincial Strategy for end-of-life care in British Columbia pub-lished in October 2002.health.gov.bc.ca
  • The Patients Property Act. qp.gov.bc.ca
  • The Health Care (Consent) and Care Facility (Admission) Act.qp.gov.bc.ca
  • The Representation Agreement Act. qp.gov.bc.ca
  • The Adult Guardianship and Planning Statutes Amendment Act, 2007. leg.bc.ca
  • The BC Ministry of Health has published document on end-of-life planning: 

Canadian reports

International reports

  • Australian Government: Department of Health and Ageing. The National Palliative Care Strategy - A National Framework for Palliative Care Service Development – October 2000. health.gov.au

  • Last Acts Committee. (2002, November). Means to a better end: A report on dying in America today. Washington, DC: Last Acts.
  • Mid-Atlantic Renal Coalition. (no date). Recommendations for addressing EOL in ESRD. Midlothian, VA.
  • Moss, A. (Ed.). (2003, March). Completing the continuum of Nephrology care end-stage renal disease peer workgroup: Recommendations to the Field (Promoting Excellence in End of Life Care). The Robert Wood Johnson Foundation.
  • National Association of Social Workers (NASW). NASW Standards for Social Work Practive in Palliative and End of Life Care.
    socialworkers.org
  • National Health Services (NHS) Department of Health (DH). The National Service Framework for Renal Services.
    dh.gov.uk
  • National Health Services (NHS) End-of-Life Care Programme. The Gold Standards Framework: A Programme for Community Palliative Care.
    goldstandardsframework.nhs.uk
  • National Health Services (NHS) National End of Life Care Programme / The University of Nottingham.
  • National LCP Renal Steering Group. (June 2008). Liverpool care pathway for the dying patient: Guidelines for LCP drug prescribing in advanced chronic kidney disease. Liverpool, UK: Marie Curie Palliative Care Institute
  • Program of Experience in the Palliative Approach (PEPA).
    pepaeducation.com
  • Promoting Excellence in End-of-Life Care offers a section on Palliative Care Tools Listed by Grantee (Demonstration Project) and National Workgroup.
    promotingexcellence.org
  • Renal supportive and end-of-life care: a one day workshop organized by the Department of Health on Monday, April 14th, 2008.
    dh.gov.uk
  • Stanton, P., & Noda, B. (2008, April). Renal end of life care action planning: Thematic analysis of outcomes from a DH stakeholder event held at Prospero House on 14th April, 2008. PowerPoint presented at the Renal supportive and end of life care: A one-day workshop.
  • The Royal Australian College of General Practitioners (RACGP) Advance Care Planning guidelines with links to a few more articles.
    racgp.org.au
  • The UK’s National Health Services (NHS) Department of Health (DH) published a document on 16 July, 2008, outlining England’s end-of-life care strategy: End of Life Care Strategy – promoting high quality care for all adults at the end of life.
  • The Marie Curie Palliative Care Institute of Liverpool provides several resource
 
 

These are some professional organizations’ position statements and standards of practice:

 


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SOURCE: Palliative Care ( )
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