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Palliative Care

Hospice Palliative Care Admission Criteria

Goals of care need to be discussed with the patient or Substitute Decision Maker/POA Care prior to referral so triage to the appropriate level of care can occur.


Discharge planning will be initiated for patients whose condition stabilizes and who have care needs that can be met in another care environment.

 

Referred patients must meet all criteria outlined below for eligibility


Eligibility criteria for admission

 

Palliative Home Care
Community Care Access Centre 

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Bruyère
Palliative Care Unit


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Hospice Care Ottawa 


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 Prognosis

 Presence of a, progressive, life limiting illness (cancer or non-cancer), and who are at the end of life Presence of a progressive, life-limiting illness (cancer or non-cancer) requiring specialized palliative pain and symptom and complex end-of-life care Presence of a, progressive, life limiting illness (cancer or non-cancer), and who are at the end of life

Disease Status

<12 months

There is no prognosis criterion for admission to Bruyère’s Palliative Care Unit

 

Last days or weeks of life

Functional Status

Anticipated functional decline as disease progresses Palliative Performance Scale (PPS) not applicable

Palliative Performance Scale (PPS) is equal or less than 30 %

 

Length of Stay

<12 months Days to weeks

Last days or weeks of life

 

Goals of Care

Palliative Care Approach where patient care needs can be supported with combined caregiver support and CCAC services in a safe community environment Management of complex and/or acute pain and symptom crises across the illness trajectory, including the end of life

There is no requirement that a Do Not Resuscitate (DNR) order be in place
Patients admitted have a primary goal of comfort care at the end of life

Patients must have a Do Not Resuscitate (DNR) order in place at time of referral and end of life goals have been clarified with patient/SDM

 

Complexity Level

Complexity that can be cared for at home Have complex needs that require intensive daily follow-up by a palliative care Physician Patients have care needs that cannot be managed in their home or do not wish a home death

Patients’ needs are relatively low in complexity

 

Examples of Care Needs
(not exhaustive)

  •  Nursing Care
  • Personal Support Services
  • PT, OT, SW, SLP, RD
  • Medical Supplies & Equipment
  • Ongoing Case Management
In the community CCAC also offers: system navigation, linkages with Family Health Teams & community Palliative Care Physicians, RPCT and referrals to community resources (e.g. day hospice programs; in-home hospice volunteers; bereavement support).

CCAC does not provide 24 hour/day care at end of life.

Contact CCAC for further information.
  •  Neuraxial block management (intrathecal or epidural) in the post insertion phase (greater than 24-72 hours)
  • Complex trach care
  • Indwelling chest or abdominal drainage tube
  • BIPAP & CPAP
  • Patients still receiving chemotherapy and radiation with palliative intent.
  • Switch/rotation to methadone
  • Initiate and titrate Ketamine
  • Management of complex wound care
  • Patients with severe agitated delirium
  • Total parenteral nutrition
  • Blood and platelet transfusion
  • Stable Neuraxial block management in the maintenance stage (greater than 5 days post insertion)
  • Stable trach care
  • Indwelling chest or abdominal drainage tube
  • BIPAP & CPAP will be assessed on an individual basis
  • Patients no longer receiving chemotherapy and or radiation

HCO does not accept:

  • Patients with active TB, C. difficile positive, wandering and/or exit seeking
  • Patients requiring enteral feeding or transfusions
  • Patients/families who pose a risk of violence or harm to self/others