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ALERT: Improving End of Life Care in Long Term Care

Updated: Sep 14, 2022

Home Hospice Association is excited to announce our Four Point Plan to improve end of life care in Long Term Care Facilities.

Four Point Plan for End of Life Care in Long Term Care Facilities

Most residents of long term care facilities will live there until their lives end. As a resident’s end of life draws near, they and their immediate family have powerful emotional needs, which are frequently unmet. This often leads them to believe that the LTC staff should be providing more physical care to the dying resident.

It’s difficult and time consuming for LTC staff to convince distraught residents and their immediate families that all of the dying resident’s physical needs are being met. Frequently, residents in the end of life process or their immediate families cannot be persuaded because their fears are too powerful to be satisfied by logic and facts.

Therefore, staff are often forced to endure inappropriate supervision from the resident’s family members who can also get in the way. Staff can be pressured into providing unnecessary physical care in an attempt to satisfy emotional needs, which wastes time that is needed for other residents.

Not knowing what to expect or “what is happening” when a loved one is actively dying, families may blame staff for “killing their loved one” when what they are witnessing is simply the body’s natural process of shutting down.

These emotional needs can cause complaints throughout the LTC system, reaching all the way to the Ministry with stops along the way at media resources like “Consumer Alerts” on CTV. Public opinion is then formed by the emotions of dying being a part of living, not the facts of providing the necessary care to the people who need it. Then the LTC must spend time and resources on unreasonable and counter-productive emotional demands. Sometimes this even gets to the point of defending lawsuits.

HHA’s Four Point Plan addresses the needs of everyone involved in long term care settings: staff, management, volunteers, family, and residents.

In Support of the Staff and Volunteers in Partnering Facilities

  • HHA provides significant training (both online / in independent study as well as in-facility workshops) that addresses both the practical needs of those reaching their end of life as well as of professional caregivers.

  • Access is offered to our De-Briefing Support Team, which is available 24 hours a day, to provide immediate emotional support to professional caregivers who have “just lost” a resident. This means that staff (who often have had a deeper relationship to a resident than the resident’s own family) have their grief honoured and recognized.

  • The addition of Death Doula Candidates gives the current care team a chance to understand this complimentary role in a collaborative / “non-threatening” way.

  • Further, the addition of Death Doula Candidates gives the LTC facility a chance to experience “proof of concept,” which makes it easier to consider an increase in operational budgets to bring an HHA Certified End of Life Doula onto their staff permanently.

In Support of the Residents in Partnering Facilities

  • One-on-one care and support is given for residents’ non-medical needs at the end of life.

  • A compassionate ear helps residents work on or work through issues that they may not be comfortable sharing with family.

  • Respect for the journey the residents are on especially when dementia has robbed someone of much of their dignity.

  • Acknowledgement of who they are culturally, socially and spiritually.

  • A chance to die in the manner of their choosing, which ensures that they do not die alone or in distress.

Just as it takes a village to raise a child, that village is equally necessary at the end of our lives. We are excited to draw our circle of care to embrace Long Term Care Facilities all across Canada, and we are proud of our role in pioneering the Death Doula Movement. To learn more about this initiative and determine if or how you would like to be involved, visit our new webpage:

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