1. SIX STEPS TO SUCCESS IN CARE HOMES by Rachel Moorhouse End Of Life Care Facilitator for Care Homes

3. SIX STEPS T0 SUCCESS
Step 1 - Discussions as the end of life approaches
Step 2 - Assessment, care planning and review
Step 3 - Co-ordination of care
Step 4 - Delivery of high quality care in care homes
Step 5 - Care in the last days of life
Step 6 - Care after death

4. Adapted from The North West End of Life Care
Model
‘Liverpool Care Pathway for the Dying’ (LCP)
Last Days of Life
First Days after Death
1 year
Advancing disease
Bereavement
6 months 1 2 3 5
The North West End of Life Care Model 4
Death
Increasing decline
‘Rapid Discharge Pathway’ (RDP)
Six Steps to Success programme
Advance Care Planning
Preferred Priorities for Care (PPC)
Advance Decision to Refuse Treatment
(ADRT)
Lasting Power of Attorney (LPA)
End of
Life Care
Tools

7. ACP
&
Communication Day
Interactive session on communication skills including practical demonstrations
Discussing DNA/CPR
Advance Care Planning
Best Interest Discussions
ADRT

8. LCP Study Day
Appropriate hospital admissions and Significant event analysis
Diagnosing dying
Multi- disciplinary team discussions,
DNACPR
Nutrition/ hydration
Communication to relatives/ carers
GP review
Commencement of the Liverpool Care of the Dying Pathway
Facilitating conversations with relatives & carers
Religious, spiritual and cultural care
Symptom
Care after death

9. What do we expect? Residents placed on end of life register
Shared Communication
Advance Care Planning
End of life care policy
Review holistic assessment to include end of life care/ wishes
Involve residents/ families/ all staff
Every resident to have an eolc key worker

10. All staff to know key contacts
Review training needs of staff
Dignity Champion
Review the environment
Understand the LCP- last hours /days of life
Review bereavement policy
Audit
Completed portfolio

12. The Future 8 nursing homes to start the programme January 2013
Residential cohort summer 2013
McKinley training offered to all nursing homes who have completed six steps/GSF
Verification of death in nursing homes
Broader education and support
Integration with hospital and community end of life care events

13. Thank you
Any questions?