Practice Recommendations

Recommendation Question #1: Should an interprofessional approach be recommended for the provision of care to adults in the last 12 months of life?

Outcomes: Person and family experience with care; effectiveness of provided care from the person and family perspective; access to care; coordination of care; transitions in care; effectiveness of provided care from the health provider perspective

Recommendation 1.1: The expert panel recommends that health-service organizations implement an interprofessional model of care for the provision of palliative care and end-of-life care to persons and families.

Recommendation Question #2: What nurse-led interventions should be recommended for a palliative approach to the delivery of care in the last 12 months of life?

Outcomes: Support for spiritual care; support for emotional care; support for existential care; care in alignment with the person’s wishes; culturally safe care; place of death.

The following recommendations are applicable within the context of an interprofessional health team (see Recommendations 1.1 and 1.2).

Recommendation 2.1: The expert panel recommends that nurses assess the cultural needs and values of persons and families.

Recommendation 2.2: The expert panel recommends that nurses perform ongoing assessments of persons and families for the following:

• values, beliefs, expectations and preferences about progressive life-limiting illness and death; and

• preferred place of death

Strong

Recommendation 2.3: The expert panel suggests that as part of a holistic assessment, nurses assess the spiritual, emotional and existential needs of persons and families, including:

• concerns about end of life; and

presence of spiritual, emotional and existential distress

Conditional

Recommendation 2.4: The expert panel recommends that nurses address the person’s and family’s palliative care and end-of-life care expectations.

Strong

Recommendation 2.5: The expert panel suggests that nurses provide opportunities for life reflection to persons and families.

Conditional

Recommendation 2.6: The expert panel recommends that nurses facilitate access to resources, space and services needed by persons and families for cultural, spiritual and/or religious practices

Strong

Recommendation 2.7: The expert panel recommends that for persons who prefer to die at home, health-service organizations implement high-quality home and community care, which includes:

• access to after-hours services;
• care coordination; and

support provided by an interprofessional health team.

Strong

Recommendation Question #3: Should continuing education, targeted skills training and debriefing be recommended for supporting nurses and the interprofessional health team who provide care to persons in the last 12 months of life and their families?

• Outcomes: Compassion fatigue; stress/distress; resilience