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End of life care

The latest research shows that healthcare providers and their elderly patients find it difficult to talk about how much time someone has left and how they’d like to be cared for as they near the end of life. With an aging population and an increase in treatment options to keep us living longer (if not always better) than ever before, it’s more important than ever to plan for the medical treatment or palliative care you would like to receive.

Home palliative care a key to respecting end of life wishes
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Advance care planning and intensive care: Planning ahead for your end of life wishes
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Transitioning to end of life care: Communication is key
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  • Evidence Summary

    End-of-life care pathways for improving outcomes in caring for the dying

    Cochrane database of systematic reviews (2010)
  • Evidence Summary

    Case management programs may have benefits for informal caregivers  

    International Journal of Geriatric Psychiatry (2017)
  • Web Resource Rating

    Treating pressure ulcers: New evidence, continued uncertainty

    Evidently Cochrane
    Gauze dressings should not be used to treat pressure ulcers (bed sores). Other options include alginate dressings, hydrogel dressings, and negative pressure wound therapy. More evidence is needed about which options are best to improve pain and reduce complications. Research should measure outcomes that matter to patients and carers as well as health professionals.
  • Evidence Summary

    Hospital at home: Home-based end of life care

    Cochrane Database of Systematic Reviews (2011)
  • Evidence Summary

    Hospital at home: home-based end-of-life care.

    Cochrane Database Syst Rev (2016)
  • Evidence Summary

    Early palliative care for adults with advanced cancer.

    Cochrane Database Syst Rev (2017)
  • Patient Decision Aid

    Advance Care Planning: Should I stop kidney dialysis?

    OHRI
    This patient decision aid helps people with kidney failure currently undergoing dialysis, and for whom kidney transplantation is not possible, decide on whether or not to stop the treatment. It facilitates the process by comparing the benefits, risks and side effects of both options.
  • Patient Decision Aid

    A Decision Aid to Prepare Patients And Their Families For Shared Decision-Making About Cardio-Pulmonary Resuscitation (CPR)

    OHRI
    This patient decision aid helps seriously ill patients who are older and/or have advanced medical illness and a high near-term risk of death and their families decide whether or not to have cardio-pulmonary resuscitation (CPR) treatment.
  • Web Resource Rating

    Hospital at home increases the chances of dying at home

    Evidently Cochrane
    Research evidence shows that home-based end of life care increases the chances that people will die at home. It may not be everyone's preference to die at home and a person's preferred place for end of life care can change as their symptoms and illness change.
  • Web Resource Rating

    Palliative care: Who is it for?

    Mayo Clinic
    Palliative care focuses on providing relief from symptoms and stress you may experience during treatment for a serious illness. Read more to learn about whether or not palliative care may be right for you.
  • Web Resource Rating

    Top ten things to know: Decision making in advanced heart failure

    American Heart Association
    It is important that doctors and patients work together to make decisions about advanced heart failure. Developing an end-of-life care plan that meets your values, goals and preferences will help to simplify decisions later on.
  • Web Resource Rating

    Hospice care: Comforting the terminally ill

    Mayo Clinic
    Consider hospice care for those who are terminally ill. Hospice care focuses on maintaining a high quality of life during the final months and days of life. This resource includes tips to help you select a hospice program.
  • Web Resource Rating

    Terminal illness: Supporting a terminally ill loved one

    Mayo Clinic
    Knowing how to offer comfort to a loved one with a terminal illness can be hard. Speak with them about the life they have lived and provide emotional support. Hospice and palliative care experts are a great resource for people with terminal illness and their caregivers.
  • Web Resource Rating

    Anxiety

    Canadian Virtual Hospice
    Symptoms of anxiety include: racing thoughts, fast heart rate, shortness of breath, nausea and trouble sleeping. Some people may have panic attacks. This resource includes tips to help you recognize and cope with anxiety.
  • Web Resource Rating

    Is supporting caregivers of the terminally ill effective?

    Evidently Cochrane
    Supporting caregivers whose relatives are dying can lower their distress and may improve their quality of life and ability to cope. However, among some caregivers, support increased family conflict and did not help improve their sleep.
  • Web Resource Rating

    Comparing End-of-Life Care Options

    Aging Care
    Choosing an end of life care option is a decision that depends on your personal needs and financial limits. There are also different places you can access end of life care such as the hospital or at home. Read this resource to learn more about these different options and the financial supports available to you in the United States.
  • Patient Decision Aid

    Understanding the Options: Planning care for critically ill patients in the Intensive Care Unit.

    OHRI
    This patient decision aid helps family members (including surrogate decision maker) of a patient admitted to the intensive care unit decide between life support and comfort care by comparing the benefits, risks, and side effects of both options.
  • Web Resource Rating

    How do you know you've done the right thing?

    Canadian Virtual Hospice
    As a substitute decision maker for someone with a terminal illness it might be difficult to know if you have made the right choices. Feeling sad does not mean you did the wrong thing. Think about honouring and respecting your loved one.
  • Web Resource Rating

    Ensure Your Wishes Are Followed

    Dying with Dignity Canada
    End of Life Planning Canada's Advance Care Planning Kits is a tool that can help communicate your end of life wishes when you are no longer able to yourself. This resource includes some of these points of consideration.
  • Web Resource Rating

    Download An Advance Care Planning Kit

    Dying with Dignity Canada
    An Advance Care Planning Kit will help you discuss your wishes for your end of life. Some requirements differ per province. Access this resource to get an Advance Care Planning Kit tailored to your province.
  • Web Resource Rating

    End-of-Life Care

    British Columbia Family & Social Supports
    The end of life is a very sensitive time for everyone involved. End of life care or palliative care is provided by the Ministry of Health in British Columbia. Read this resource to learn about options for care and government benefit programs.
  • Web Resource Rating

    How Palliative Care Helps Achieve Quality of Life

    Aging Care
    Palliative care supports people with serious illness, whether it is curable, chronic, or life-threatening. It helps people relieve symptoms, access emotional and spiritual support, and navigate the healthcare system. Learn more about palliative care and how it works by reading this resource.
  • Web Resource Rating

    Answers to Common Questions About End-of-Life Care

    Aging Care
    End of life can be a difficult time for people caring for their loved ones. Knowing the answers to some common questions can help you prepare. Read this resource to learn more about how to support your loved one during their end of life.
  • Web Resource Rating

    End of life issues

    Age UK
    The end of life is a time to make important decisions about your care, your legacy and your loved ones. Read this resource to learn more about how you can approach end of life in a way that feels right to you.
  • Web Resource Rating

    Do you have a Will?

    Retire Happy
    Only half of Canadians have a will. This leaves loved ones unsure of how to proceed with estates and other assets. Use this resource to learn how about the downfalls of not having a will and how you can get started the process started to plan for the future.
  • Web Resource Rating

    Understanding and responding to elder abuse

    Government of BC
    If you suspect any type of elder abuse, use this governmental resource as a complete guide to understanding different types of abuse, how to respond, available government resources and ways to ensure a safe environment for both yourself and the victim.
  • Web Resource Rating

    Guardianship

    Seniors First BC
    When someone is unable to make decisions due to incapacity or disability, a legal guardian is appointed. Use this resource to learn the difference between a guardian of the person and a guardian of the estate and the responsibilities of each role.
  • Web Resource Rating

    It's your choice: Personal Planning Tools

    Public Guardian and Trustee of British Columbia
    If you are incapable of making your own decisions in the future due to unforeseen circumstances, you can prepare in advance to make sure your wishes are carried out. In order to start planning your personal affairs, consider using this resource to learn more about powers of attorney, adult legal guardianships and advance directives.
  • Web Resource Rating

    Information for Temporary Substitute Decision Makers Authorized by the Public Guardian and Trustee

    Public Guardian and Trustee of British Columbia
    Consider starting to plan in case you are unable to make your own decisions in the future. Learn how a temporary substitute decision maker appointed by a health care provider or a public guardian and trustee can make decisions on your behalf and what restrictions they have when making decisions.
  • Web Resource Rating

    Consent to health care and the role of the public guardian and trustee

    Public Guardian and Trustee of British Columbia
    When an adult is unable to make independent decisions, a substitute decision maker must be appointed. Understand the role of the public guardian and trustee by reading this factsheet.
  • Web Resource Rating

    Duties and Powers of a guardian of property

    Ontario Ministry of the Attorney General
    If you have been appointed as a guardian of property, use this resource to learn about your legal responsibilities and authority. In this role, you are allowed to make decisions on behalf of the incapable person’s property but you cannot make a will.
  • Web Resource Rating

    Becoming a guardian of property

    Ontario Ministry of the Attorney General
    This resource answers all your questions on becoming a guardian of property and outlines the process of being appointed as well as responsibilities and limitations to authority.
  • Web Resource Rating

    A Guide for the Caregiver

    Government of Manitoba - Health, Seniors and Active Living
    Taking on the role of caregiver for a senior can be a mentally and physically draining task. Use this resource as a guide to help you navigate your new role. Topics covered include counselling services, housing, hospitalization, end of life care, legal matters and other support services.
  • Web Resource Rating

    Where Can I Get End-of-Life Care?

    National Institute on Aging
    If you are looking for more information on end of life care, use this resource to learn about the differences between hospital care, nursing homes or comfort care in your own home.
  • Web Resource Rating

    Understanding Healthcare Decisions at the End of Life

    National Institute on Aging
    If you are being asked to make healthcare decisions for someone who has a terminal illness, it can be overwhelming to make these decisions alone. Consider using this resource to learn about two methods you can use to make the process a little easier; substituted judgement and best interests.
  • Web Resource Rating

    Advance care planning

    National Institute on Aging
    Advance care planning is an important part of decision making near the end of life. Use this resource to guide you through this process and ensure that you are fully informed about your options in regard to powers of attorney and wills.
  • Web Resource Rating

    End of life: Helping with comfort and care

    National Institute on Aging
    If you are a caregiver for a senior who is nearing the end of their life, consider using this resource to be a better caregiver for them and to learn about ways to cope with your grief after their death.
  • Web Resource Rating

    Providing Comfort at the End of Life

    National Institute on Aging
    If someone you love is dying or has a terminal illness, use this resource to learn how you can best support them through this difficult time. Read about the four areas that should be addressed before death which include physical comfort, mental and emotional needs, spiritual issues and practical tasks.
  • Web Resource Rating

    Information for seniors about benefits, services, and planning for the future

    ClickLaw
    This resource is for people aged 60 or older and describes benefits, services and other programs they are eligible to receive in British Columbia.
  • Web Resource Rating

    Dying Without a Will

    ClickLaw
    Use this resource to learn about the importance of writing a will and follow the steps outlined to help you with the process.
  • Patient Decision Aid

    Advance Care Planning: Should I receive CPR and life support?

    OHRI
    This patient decision aid helps individuals with a very serious illness decide on whether or not to receive CPR and life support by comparing the benefits, risks and side effects of both options.
  • Patient Decision Aid

    Advance Care Planning: Should I have artificial hydration and nutrition?

    OHRI
    This patient decision aid helps people decide on whether or not to have artificial hydration and nutrition if or when they are no longer able to take food or fluids by mouth by comparing the benefits, risks, and side effects of both options.
  • Patient Decision Aid

    Advance Care Planning: Should I stop treatment that prolongs my life?

    OHRI
    This patient decision aid helps people with a life-limiting illness or disease decide on whether or not to stop life prolonging treatment by comparing the benefits, risks, and side effects of both options.
  • Patient Decision Aid

    Autopsy: Should I have an autopsy done on my loved one?

    OHRI
    This patient decision aid helps people decide on whether or not to have an autopsy done after the death of a loved one by comparing the benefits, risks, and side effects of both options.
  • Web Resource Rating

    Grief work

    Canadian Virtual Hospice
    Grief can affect us all in different ways. Activities such as writing down your emotions, becoming involved in a group or exercising may help you deal with your grief. This resource includes guidance for dealing with grief.
  • Web Resource Rating

    Finding meaning and purpose during a health crisis

    Canadian Virtual Hospice
    Remember that your life has value no matter how sick your body may be. Read this resource for suggestions about how to rebuild your sense of meaning and purpose during a health crisis.
  • Web Resource Rating

    Wills

    Canadian Virtual Hospice
    Make a will to make sure your wishes are carried out after you pass away. A standardized will or a lawyer can help you write your will and choose an executor.
  • Web Resource Rating

    Guilt, regret, forgiveness, reconciliation

    Canadian Virtual Hospice
    You may feel guilt as you reach the end of your life about things you did or did not do. Making peace with old relationships and forgiving yourself and others may bring emotional healing.
  • Web Resource Rating

    Hope and denial

    Canadian Virtual Hospice
    Having hope can help you cope with a terminal illness. Caring relationships, telling your story, managing your symptoms, humour and spirituality can help you maintain hope.
  • Web Resource Rating

    Spirituality and life-limiting illness

    Canadian Virtual Hospice
    A terminal illness may cause you to think seriously about death and dying. You may have spiritual questions about relationships and the meaning of life. Talking about spiritual feelings may help you cope and improve your quality of life.
  • Web Resource Rating

    Finding a spiritual companion

    Canadian Virtual Hospice
    You might find that a spiritual companion helps you talk about your feelings when you are dying. Your spiritual companion can be anyone that you can talk to, like family or friends.
  • Web Resource Rating

    Rituals for patients and families

    Canadian Virtual Hospice
    You can create a ritual for your family to continue after you pass away. You might like to include a tradition, writing letters, or arranging a visit to a special place together.
  • Web Resource Rating

    Sorting out health concerns

    Canadian Virtual Hospice
    To help your health care team, write down your health concerns and symptoms in detail. This resource includes questions you can consider. This can lead to a physical examination or tests.
  • Web Resource Rating

    Palliative care: Confusion

    Canadian Virtual Hospice
    Confusion may be a sign of dementia or delirium, but can also be caused by medications, pain, infections or other issues. Speak with your healthcare team to find out what is causing the confusion and what you can do about it.
  • Web Resource Rating

    Nausea and vomiting

    Canadian Virtual Hospice
    There are many causes of nausea and vomiting. Relaxation, medications, or eating bland food may help. Tips in this resource to recognize when to call your doctor.
  • Web Resource Rating

    Help with bathing

    Canadian Virtual Hospice
    You can help your loved one feel more comfortable by offering them help with bathing. Ask first since some people prefer bathing to be done by health care professionals. Tips in this resource for bathing and sponge baths.
  • Web Resource Rating

    Help with toileting

    Canadian Virtual Hospice
    Installing grip rails, easy access to toilet paper, a high toilet seat and a dry floor all help to keep a bathroom safe and accessible. If you can no longer get to the bathroom there are other options.
  • Web Resource Rating

    How long have I got?

    Canadian Virtual Hospice
    If you have a terminal illness, you may want an indication of how much time you have left. This is normal but it is very difficult to give a perfectly accurate prediction.
  • Web Resource Rating

    Health care directives

    Canadian Virtual Hospice
    Consider writing down your health care directives in case you lose the ability to make decisions about treatment. Remember to update them if you change your mind and let a loved one know your wishes.
  • Web Resource Rating

    Children at the bedside of a dying family member or friend

    Canadian Virtual Hospice
    Children may want to spend time with their dying loved one. Prepare them for the visit, answer their questions honestly, and show them experiencing grief is normal.
  • Web Resource Rating

    When death is near

    Canadian Virtual Hospice
    People with a terminal illness and their caregivers may have questions about dying, including about pain, physical changes, eating, confusion and decreased energy. This resource provides information about common concerns.
  • Web Resource Rating

    Stress and distress

    Canadian Virtual Hospice
    Stress symptoms include muscle tension, sweaty palms, shortness of breath and dizziness. This resource includes tips to identify the source of your stress and strategies to cope with and reduce your stress.
  • Web Resource Rating

    Tips for talking with your health care providers

    Canadian Virtual Hospice
    Make a list of what you want to discuss before seeing your health care provider. Bring up what's important to you, including your emotions and concerns. Stick to the topic, be honest and make sure you understand everything. Ask about different options.
  • Web Resource Rating

    Tips for visiting

    Canadian Virtual Hospice
    When visiting a loved one, call ahead and avoid interfering with regular schedules. Offer to help with errands and be sensitive to the person's needs and wishes.
  • Web Resource Rating

    What do I say?

    Canadian Virtual Hospice
    Be yourself when talking to someone with an illness. Think about what you would have talked about together before the person was sick. Be sensitive, listen carefully and provide reassurance.
  • Web Resource Rating

    Advanced care planning across Canada

    Canadian Virtual Hospice
    Think about advance care planning options and talk about your wishes for your health care. Choose a person you trust to speak on your behalf. You can change your advance care plan at any time.
  • Web Resource Rating

    Mindfulness: Making moments matter

    Canadian Virtual Hospice
    Practice mindfulness for better well-being. Notice your breathing, thoughts and feelings, and adopt a non-judging, patient, trustful and accepting attitude. This resource includes tips to cultivate mindfulness.
  • Web Resource Rating

    Sharing your story

    Canadian Virtual Hospice
    Sharing your personal illness story can help you reflect on and cope with your illness experience. This resource has guidance about how to think about and share your story.
  • Web Resource Rating

    Sleep disturbance

    Canadian Virtual Hospice
    Poor sleep is common for people with advanced illness. Minimize time in bed and naps during the day, create a comfortable sleep environment and stick to a bedtime routine. Talk to your health care team to help treat poor sleep.
  • Web Resource Rating

    Dehydration

    Canadian Virtual Hospice
    Dehydration can be common at end of life. Treatment for dehydration can help if the person is confused, delirious, has nausea, diarrhea or side effects from pain medication. Tips for treatment in this resource.
  • Web Resource Rating

    Depression

    Canadian Virtual Hospice
    Medications, stress and advanced illness can all contribute to depression at end of life. This resource includes tips for recognizing and treating depression. Remember medications for depression take time to work.
  • Web Resource Rating

    Fatigue

    Canadian Virtual Hospice
    Serious illness can cause extreme tiredness and lack of energy. Try to plan your day, have a sleep routine and try relaxation strategies. Medications may help.
  • Web Resource Rating

    Shortness of breath

    Canadian Virtual Hospice
    To help you breathe when you feel short of breath try to lower stress, sit upright, open windows and avoid cigarette smoke. Relax with breathing exercises, distractions or massage. See your doctor for treatment options.
  • Web Resource Rating

    Help with eating

    Canadian Virtual Hospice
    People with a terminal illness may not eat as much as they used to. Try to provide high protein and high calorie snacks. Make meal times social, but do not force a person to eat.
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    Care of the mouth

    Canadian Virtual Hospice
    People with advanced illness may experience dry mouth, mouth sores and other discomforts. Mouth care 3-4 times a day can bring comfort, prevent infections and ease absorption of medications. Tips for caregiving in this resource.
  • Web Resource Rating

    Caring for hair and face

    Canadian Virtual Hospice
    It is thoughtful and brings comfort to keep a person's hair and face clean and cared for in advanced stages of illness. Tips here for washing hair in bed, shaving and face care. Lubricants can help ease dryness around oxygen tubes.
  • Web Resource Rating

    Considerations for a home death

    Canadian Virtual Hospice
    Many people would like to die in their own homes where they feel more comfortable. This resource includes tips and considerations to help you choose and prepare for a home death.
  • Web Resource Rating

    Preventing pressure sores

    Canadian Virtual Hospice
    Pressure sores are caused by lying or sitting down in one position for a long period of time. To treat pressure sores: clean skin daily, use moisturizer, and avoid hot water. Make sure clothes and sheets are clean and without wrinkles, and change positions every two hours. Find more tips here.
  • Web Resource Rating

    POLST programs: When advance directives aren't enough

    Aging Care
    Be prepared for end-of-life choices. Learn about programs that formalize end-of-life care plans like the use of CPR, antibiotics, feeding and hydration tubes for very frail or terminally ill people. Talk to your doctors and family about end-of-life care and create a plan.
  • Blog Post

    Having ‘the talk’: The benefits of making your wishes known about end-of-life care

    Advance care planning and having discussions about end-of-life care with family members and healthcare providers can have positive impacts for everyone involved.
  • Blog Post

    Does caregiver stress affect the move to long term care?

    Providing care for family members with challenging chronic diseases like dementia can be highly stressful and take a toll on caregivers’ physical and psychological health. When caregivers become “burnt out” are their loved ones more likely to be placed in long term care facilities?
  • Blog Post

    Transitioning to end of life care: Communication is key

    The latest research shows healthcare providers and their elderly patients find it difficult to talk about end-of-life prognosis and preferences for care. Dr. John You – a doctor and expert in end-of-life communication – shares his perspective.
  • Blog Post

    Advance care planning and intensive care: Planning ahead for your end of life wishes

    Patients who have an advance care plan are less likely to receive unwanted intensive care in hospital. Dr. Michelle Howard – an expert in end-of-life communication – provides a professional view on the topic and citizen contributor Diane shares her personal experience.
  • Blog Post

    Home palliative care a key to respecting end of life wishes

    Home palliative care – provided by specially trained health professionals – increases the likelihood of a patient dying at home and may even help to ease symptoms.
  • Blog Post

    Caring for the caregivers: Who is meeting the care needs of older adults?

    Families of older adults continue to provide the vast majority of care for their members when necessary. Changes in modern society necessitate support for them from the formal healthcare system.

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