Palliative care for older people - World Health Organization ...

More documents

Recommendations

Info

14Integrated care pathwaysCare pathways are structured multidisciplinarycare plans that detail essential steps in the care ofpeople with a specific clinical problem and describetheir expected clinical course (1).They can provide a link between the establishmentof clinical guidelines and their use and can help incommunicating with the people who need care bygiving them access to a clearly written summary oftheir expected care plan and progress over time.Care pathways can help promote teamwork andpatient-centred care.Such care pathways for palliative and end-oflifecare have been developed in several countries,including for inpatients (2) and oncology units(3) in the United States of America and in othersettings (4).© Joan TenoBox 14.1. Liverpool Care Pathway for the Dying PatientThe Liverpool Care Pathway (LCP) has been developed in the United Kingdom to transfer the hospice modelof care for people who are dying into other care settings (5). The pathway has been modified for people withother conditions, such as kidney disease, heart failure and dementia (6) and has been successfully disseminatedin 18 countries outside the United Kingdom. The LCP has been adapted to Australia’s health care setting (7)and has been successfully implemented in the Hong Kong Special Administrative Region of China (8). The LCPhas been translated into Dutch and tested in three settings in the Netherlands: hospital, nursing homes andhome care (9). Everyone in the dying phase was put on the pathway. During the period when the pathwaywas being used, documentation of care was more comprehensive and there was a reduction in the symptomsas reported by staff or bereaved relatives. The LCP is now being tested for effectiveness in a multicentrerandomized controlled trial in six regions of Italy.Source: personal communication, Massimo Costantini, Regional Palliative Care Network, National Institute for Cancer Research, Genoa, Italy.44
References1. Campbell H et al. Integrated care pathways. British MedicalJournal, 1998, 316:133–137.2. Bailey FA et al. Improving processes of hospital care duringthe last hours of life. Archives of Internal Medicine, 2005,165:1722–1727.3. Luhrs CA et al. Pilot of a pathway to improve the care ofimminently dying oncology inpatients in a Veterans Affairsmedical center. Journal of Pain and Symptom Management,2005, 29:544–551.4. Ellershaw J, Wilkinson S, eds. Care of the dying: a pathwayto excellence. Oxford, Oxford University Press, 2003.5. Liverpool Care Pathway for the Dying Patient (LCP) [web site].Liverpool, Marie Curie Palliative Care Institute, 2010 (http://www.mcpcil.org.uk/liverpool-care-pathway/index.htm,accessed 1 December 2010).6. McClelland B et al. End-of-life care: an evaluation of theimplementation of the Gold Standards Framework andthe Liverpool Care Pathway for people with dementia infive care settings across Greater Manchester EvaluationReport. Executive summary. London, Department ofHealth, 2008 (http://www.dhcarenetworks.org.uk/_library/Resources/Dementia/End_of_Life_Care_-_Evaluation_of_the_Implementation.pdf, accessed 1 December 2010).7. Jackson K, Mooney C, Campbell D. The development andimplementation of the pathway for improving the care of thedying in general medical wards. Internal Medicine Journal,2009, 39:695–699.8. Lo SH et al. The implementation of an end-of-life integratedcare pathway in a Chinese population. International Journal ofPalliative Nursing, 2009, 15:384–388.9. Veerbeek L et al. The effect of the Liverpool Care Pathwayfor the dying: a multicentre study. Palliative Medicine, 2008,22:145–151.© Joan Teno45
Page 1:
PALLIATIVE CAREFOR OLDER PEOPLE:BET
Page 4 and 5: AbstractPopulations around the worl
Page 7 and 8: ForewordSocieties in the WHO Europe
Page 9 and 10: AcknowledgementsThe WHO Regional Of
Page 11 and 12: 1IntroductionPalliative care is an
Page 13 and 14: By 2050, estimates indicate that mo
Page 15 and 16: • training of health care profess
Page 17 and 18: individuals and their families. Hea
Page 20: Fig. 3.2. Factors associated with p
Page 23 and 24: (Table 4.1). After 15 years, more t
Page 25 and 26: • the last days of life and death
Page 27 and 28: Box 4.4. Gerontology Institute “1
Page 29 and 30: 5National awareness“You matter be
Page 31 and 32: 6Educational interventionsA well-pe
Page 33 and 34: Box 6.3. European Association for P
Page 35 and 36: initiated at an early stage in the
Page 37 and 38: 8Improving care for older people in
Page 39 and 40: 9Improving palliative care for olde
Page 41 and 42: Box 9.3. Training in end-of-life ca
Page 43 and 44: 10Improving palliative care for old
Page 45 and 46: References1. Higginson IJ, Sen-Gupt
Page 47 and 48: Financial help, such as the paid co
Page 49 and 50: (Box 12.2). Several drugs can often
Page 51 and 52: 13Advance care planningAdvance care
Page 53: References1. Advance care planning:
Page 57 and 58: Box 15.1. Bus rounds as an educatio
Page 59 and 60: palliative care research initiative
Page 61 and 62: References1. Currow DC et al. A fra
Page 63 and 64: • Promote public awareness of pal
Page 65 and 66: 3. Invest in creative research into
Page 67 and 68: GermanyEberhard KlaschikCentre for
Page 69 and 70: United Kingdom (continued)Marilyn K
Page 71 and 72: The Maruzza Lefebvre D’Ovidio Fou
show all

Palliative care for older people - World Health Organization ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?