Palliative care
These materials have been prepared solely for use at Interior Health (IH). IH accepts no responsibility for use of this material by any person or organization not associated with IH.
Palliative Care Clinical Resources
Access palliative and end of life care resources for health-care professionals.
Clinical Practice Supports
A wide variety of palliative tools and other resources are used within Interior Health that can help guide clinical problem-solving and decision-making for best practice palliative care.
The IH Palliative Care Nurse Consult Line is a service for Nurses who need an urgent consult with a Palliative Care Nurse for clinical assistance or direction for persons with palliative needs.
Assessment Tools
- BC Palliative Care Benefits Prescriber Guide
- BC Palliative Symptom Management Guidelines
- Confusion Assessment Method with PRISME (CAM-PRISME)
- Edmonton Symptom Assessment System Revised (ESASr Graph)
- ESASr Guidelines
- ESASr Renal
- ESASr Renal Graph
- ESASr Tool
- FICA Spiritual Assessment Tool
- OPQRSTUV Symptom Assessment Tool
- Pain Assessment in Advanced Dementia (PAINAD)
- Palliative Performance Scale (PPSv2)
- Palliative Symptom Assessment Clinical Care Standard
- SBAR for Communicating Palliative and End-of-Life Care Needs
- Serious Illness Conversation Standardized Process
- Supportive and Palliative Care Indicators Tool (SPICT™)
- IPal – APP
- Palliative Bowel Protocol
Forms
- BC Palliative Care Benefits Registration Form
- BC Palliative Care Benefits Prescriber Guide: BC Palliative Care Benefits (gov.bc.ca)
- Notification of Expected Death in the Home (EDITH) Form
- Community Hospice Bed (CHB) Referral Form
- Community Hospice Bed (CHB) Agreement Form
- Serious Illness Conversation Documentation
- External Referral Home Health (Used for all Home Health services, including Palliative Care, and replaces the Home Health Palliative Care Services Referral Form)
Pre Printed Orders (PPOs)
- Adult Palliative Symptom Management - Hospital based
- Adult Palliative Symptom Management - Community Hospice Bed and Long-term Care
- Adult Palliative Sedation Therapy
- Adult Palliative Just in Case Symptom Management Kit Prescription Form
- Palliative Symptom Management PPOs 6-month review Webinar
Copies of any palliative PPOs can be accessed through the PPO web page on the InsideNet, for those who have access, or by contacting the IH Palliative Care Office.
Tool kits
Palliative Sedation Toolkit
Clinical Decision Support Tools
- Palliative Sedation Therapy Decision Algorithm
- Respiratory Distress Observation Scale - RDOS
- Pain Assessment in Advanced Dementia Scale - PAINAD
- Richmond Agitation Sedation Scale - Palliative Version (RASS-PAL)
- Palliative Sedation Therapy Monitoring Record
- Palliative Sedation Therapy (PST) Checklist
- RASS-PAL Self Learning Module (Bruyere)
Education - Public
Education - Staff
Implantable Cardioverter Defibrillator (ICD) Deactivation Toolkit
Community Just-in-Case Symptom Management Toolkit
- Palliative Just in Case Symptom Management Kits Webinar (video)
- Palliative Just in Case Medication Kit Supplies List
- Eligibility and Opioid Diversion Risk Screen
- Client/Family In-Home Medication Record
- In-Home Palliative Just in Case (JIC) Medication Log (821470)
- Palliative Just in Case Medication Kit (821471)
- Palliative Just in Case (JIC) Symptom Management Kit (SMK) Prescription Request (821472)
- Palliative Just in Case (JIC) Symptom Management Kits (SMK) Standardized Process (821473)
- Palliative Just in Case (JIC) Symptom Management Kit (SMK) Education Checklist (821474)
- Just in Case Palliative Symptom Management Kits Pharmacy Communication Sheet
Palliative Care Clinical Practice Bulletins (CPBs)
- Palliative CPB Introduction
- Palliative CPB Issue 1 Palliative SBAR
- Palliative CPB Issue 2 Whole Community Palliative Rounds
- Palliative CPB Issue 3 Sept 30 National Day For Truth And Reconciliation
- Palliative CPB Issue 4 Pronouncement of Death
- Palliative CPB Issue 5 Partnering Well: Hospice Societies in IH
- Palliative CPB Issue 6 Diabetes Management at End Of Life
- Palliative CPB Issue 7 Provincial Symptom Management Guidelines
- Palliative CPB Issue 8 Serious Illness Conversations
- Palliative CPB Issue 9 "Just In Case": Symptom Management Kit
Best practices
Learn more about evidence-informed guidelines that support best practice in Palliative and End of Life Care.
Evidence-Informed Guidelines
- Alzheimer Canada: Late Stage Dementia
- Alzheimer Canada: End of Life Dementia
- BC Inter-professional Symptom Management Guidelines (2019)
- BC Cancer Agency Guidelines
- BC Palliative Care Guidelines
- BC Palliative Sedation Guidelines
- BC Psychosocial Guidelines: Nurturing Psychosocial and Spiritual Wellness
- BC Renal Network
- Canadian Respiratory Guidelines
- Cardiac BC: Heart Failure
- Serious Illness Conversation Standardized Process
- Supportive and Palliative Care Indicators Tool
- Whole Community Palliative Rounds Guideline
Education
View resources that will support teaching individuals and families with palliative needs as well as recommended education for the expanded inter-professional palliative team.
Health Care Provider Education
Person and Family Education
Aboriginal cultural safety resources
Interior Health recognizes that Aboriginal peoples in Canada experience health inequities as a result of the historical and ongoing impacts of colonialism. Culturally safe health care environments increase the quality of the health care services received, leading to increased service utilization and improved health outcomes. IH is committed to working with Aboriginal partners and allies to create healthy and respectful care environments and practices which are safe and welcoming for all Aboriginal peoples, their families and communities.
Many health-care providers are at different stages in their journey toward cultural safety and humility. There is information below and links to resources that support health-care providers in gaining knowledge, humility, and developing culturally safe practices.
What it means to be culturally safe
A culturally safe environment is the desired outcome and can only be defined by the Indigenous person receiving care in a manner that is safe and does not profile or discriminate against the person but is experienced as respectful, safe and allows meaningful communication and service. It is a physically, socially, emotionally and spiritually safe environment, without challenge, ignorance or denial of an individual’s identity.
To be culturally safe requires positive anti-racism stances, tools and approaches and the continuous practice of cultural humility.
Cultural humility is a life-long process of self-reflection and self-critique. It is foundational to achieving a culturally safe environment. While western models of medicine typically begin with an examination of the patient, cultural humility begins with an in-depth examination of the provider’s assumptions, beliefs and privilege embedded in their own understanding and practice, as well as the goals of the patient-provider relationship. Undertaking cultural humility allows for Indigenous voices to be front and centre and promotes patient/provider relationships based on respect, open and effective dialogue and mutual decision-making. This practice ensures Indigenous peoples are partners in the choices that impact them, and ensures they are party and present in their course of care.’
Learn more by reading the report In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in BC Health Care (2020)
Advance Care Planning
Advance care planning is thinking about and writing down your wishes or instructions for present or future personal and health-care needs in case you are not able to make decisions for yourself. It involves reflecting on spiritual, cultural, emotional and mental aspects of your well-being and how these topics guide your own advance care planning.
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