Powell River Division of Family Practice

Palliative Resource Binder

Last update: May 2017

MISCELLANEOUS ITEMS

0. a  Palliative Binder Table of Contents.pdf
0. b 2016 April SC Patient letter resource binder.pdf
1. Palliative Binder Table of Contents with Suggested Time of Use.pdf
2. Palliative Care Referral Process.pdf
 

ADVANCED CARE PLANNING (ACP)

Tools for physicians, nurse practitioners and nurses to have “The Conversation”

3. Scripted Questions for ACP - PSP.pdf
4. ACP Requirements Cheat - Sheet.pdf
5. The Conversation Starter Kit Booklet incl. Canadian legal addition.pdf
6. How to Talk to Your Doctor - TCP.pdf
7. RA7 Form - Nidus Rep Agreement.pdf
8. RA9 Form - Nidus Rep Agreement.pdf
 

FORMS & TOOLS

Benefits applications and assessments to communicate patient status

9. SPICT Form - BC Palliative Benefits Registration.pdf
10. PPS - Palliative Performance Scale - Version 2 - Powell River.pdf
11. ESAS - Edmonton Symptom Assessment System.pdf
12. Medical Certificate for EI Compassionate Care Benfits - Service Canada.pdf
13. NO CPR - Bi Cardiopulminary Resuscitation - BC Ambulance.pdf
14. Notification of Expected Death at Home.pdf
15. Red Cross Help Loan Form.pdf
16. Inter-Professional Checklist  and Discharge Meeting.pdf
17. Standing Home Order - EoL.pdf
18. Appendix B - Constipation - Medications used in Palliative Care.pdf
19. Bowel Management Guidelines.pdf
 

PATIENT HANDOUTS

Supportive information to use at various times in the palliative journey

20. Symptom Management Handout - VCH.pdf
21. When Death is Close at Hand - VCH.pdf
22. Helping Children Cope with Death - VCH.pdf
23. Dehydration at the End of Life - VCH.pdf
24. What to do When Someone Dies - VCH.pdf
25. Preparing for the Death of a Loved One - VCH.pdf
26. After Hours Palliative Nursing Service - VCH.pdf
27. If you Want to Die at Home, Consider these Steps.pdf
 

HOSPICE

Powell River Hospice referral and grief materials

28. Hospice - Palliative Berevement Client Referral Form.pdf
29. Hospice -  Volunteer Visitor Program Brochure.pdf
30. a. Hospice - Grief - After Suicide.pdf
30. b. Hospice - Grief - Children & Teens.pdf
30. c. Hospice - Grief - Coping with Challenges.pdf
30. d. Hospice - Grief - Special Days & Holidays.pdf
30. e. Hospice - Grief - Ten things to Know.pdf
30. f. Hospice - Grief - Things to Remeber when Supporting a Grieving Partner Booket.pdf
30. g. Hospice - Grief - Understanding your Emotions.pdf
30. h. Hospice - Grief - What Makes it Difficult.pdf
 

ADDITIONAL NEW RESOURCES

Public brochures developed by the Powell River Division of Family Practice

31.  All Care Support Brochure – Public brochure about Palliative care
32.  Planning for Care – Public brochure about Goals of Care and Advanced Care Planning

33. Powell River Division YouTube page for Palliative Care - A collection of patient information videos and Palliative Care training videos for nursing staff.