Discussions as End of Life Approaches
Aim: The care home will be able to identify residents who are entering the last year of life so discussions on end of life care can take place at the appropriate time.
Objectives:
- The care home will have an end of life care statement if they do not already have a statement/policy or guideline in place
- Be able to identify how the North West Model for Life Limiting Conditions supports a Supportive Care Record leading to the recognition of residents who may be in the final year of life
- Be able to identify when to undertake Advance Care Planning discussions
Joint and shared resourcesAttendance register A register that can be used at any workshops or sessions. Download:
Attendance Register v2
Evaluation form Provides feedback to the facilitators, to continually develop and improve the delivery of the programme. Download:
Evaluation form v2
Six Steps Organisational Programme Resources
PowerPoint presentation
A sample presentation that can be adapted for Step 1 workshop. Download:
Step 1 PowerPoint Presentation v5
End of life care statement
A template for care homes that require an end of life statement. Download:
End of life care statement v2
North West Model for Life Limiting Conditions and good practice guide
The model of delivery of end of life care advocated by the North West Strategic Clinical Networks. There is a Six Steps Wales version of this document available. Download:
North West Model for Life Limiting Conditions and Good Practice Guide v5
North West Model for Life Limiting Conditions template
A learning aid which supports the education around the understanding and application of the North West Model for Life Limiting Conditions. Download:
North West Model for Life Limiting Conditions Template v3
North West Model for Life Limiting Conditions template - facilitator's guide
Provides guidance to facilitators using the North West Model for Life Limiting Conditions. Download:
North West Model for Life Limiting Conditions Template - Facilitator's Guide v3
Supportive Care Record
A record for the care home to record and monitor patient care – Now updated to align with the North West Model for Life Limiting Conditions. Download:
Supportive Care Record v3
End of life care review sheet
Useful guidance to providing good end of life care (updated June 2021 to align with North West Model for Life Limiting Conditions). Download:
End of Life Care review sheet v5
SHADOW
SHADOW has been developed in the North West to assist care home staff in identifying those residents approaching the last year of life. Download SHADOW guide:
SHADOW-Six-point-guide.pdf
SHADOW communications sheet download:
SHADOW-Six-point-communications-sheet.pdf
Download SHADOW tool:
SHADOW-Six-point-tool.pdf
Proactive Identification Guidance
Aids the identification of adult patients with advanced disease in the last year/months of life who are in need of advanced supportive and palliative care (Gold Standards Framework, 2022). Download:
Proactive Identification Guidance v2022
Universal Principles for Advance Care Planning (ACP)
This document sets out six high level principles for advance care planning in England. Download:
Universal Principles for Advance Care Planning (ACP) vMarch 2022
Universal Principles for Advance Care Planning (ACP) EASY READ BOOKLET
This document sets out six high level principles for advance care planning in England in an easy read version. View here
Planning for your future care
A simple guide to Advance Care Planning and the different options open to people approaching end of life. Download:
Planning for Your Future Care v2014
. This is also available in downloadable versions in Arabic, Bengali, Mandarin Chinese, Polish, Punjabi and Urdu here
Step 1 to do list
Provides a checklist of actions that should be completed before the next workshop. Download:
Step 1 to do list v2
Six Steps to Learning Resources
The double surprise question
A simple prompt that can be used to support prognostication. Download:
The Double Surprise Question
Joan - a resident case study - long term conditions
A learning aid providing a case study around a resident with COPD. Download:
Joan - a case study with long term conditions v4
Joan - a resident case study - long term conditions, with facilitator notes
Notes for facilitators for the case study around a resident with COPD. Download:
Joan - a case study with long term conditions WITH FACILITATOR NOTES v4
Derek - a resident case study - cancer
A learning aid providing a case study around a resident with Cancer. Download:
Derek - a case study with cancer v4
Derek - a resident case study - cancer, with facilitator notes
Notes for facilitators for the case study around a resident with Cancer. Download:
Derek - a case study with cancer WITH FACILITATOR NOTES v4
Worksheet ST1.1
Worksheet to demonstrate an understanding of a Supportive Care Record. Download:
Worksheet ST1.1 v2
Worksheet ST1.2
Worksheet to recognise the different stages of end of life, and why the ‘(double) surprise’ question is used. Download:
Worksheet ST1.2 v2
Complex conversations and decisions for care home leaders
Four webinars for leaders and managers of care home to support complex and sensitive conversations in nursing practice, including planning and preparation for end of life and decision making at the end of life. Click here to visit website