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End Of Life Resources  
   
If you are looking for information on end-of-life care, here are some resources that may be useful. Be sure to visit the Kidney End-of-Life Coalition's website at www.kidneyeol.org.


Education & Training


Module 5: Caring through the End: Final Stage of Chronic Kidney Disease - This module defines palliative care and helps participants identify end-of-life issues that might arise in the facility as well as possible resources and support.


Recommendations & Guidelines


The Robert Wood Johnson Foundation's Promoting Excellence: End-Stage Renal Disease Workgroup Recommendations to the Field - This report describes the need for palliative care in the ESRD population and presents the methods, findings, recommendations, and products of the Promoting Excellence ESRD Workgroup.

Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis - The RPA's second Clinical Practice Guideline presents 9 recommendations concerning withholding or withdrawing dialysis in adult patients with either acute renal failure or end-stage renal disease. Suggested steps for dealing with disruptive patients are also included. In addition, the document includes a toolkit in which suggestions for dissemination and local implementation of the guideline recommendations are presented.

Assessing Decision-Making Capacity by Alvin Moss, M.D.

Core Curriculum on Palliative Care for Nephrologists, American Journal of Kidney Diseases, 43.1 (Jan 2004): 172-185.

Recommendations to Dialysis Units for Addressing End-of-Life Care in ESRD - eight areas that each dialysis facility should consider in offering palliative care to their patients.

RPA and ASN Position Statement on Quality Care at the End of Life

Chambers EJ, Germain M, Brown E (eds): Supportive Care for the Renal Patient. Oxford, Oxford University Press, 2004.

Campbell, Anne. "Improving retention and motivation in non-clinical dialysis employees." Nephrology News & Issues. Jan (2004): 22-27.

Lynn, Joanne, Marie W. Schall, Casey Milne, Kevin M. Nolan, Andrea Kabcenell. "Quality Improvements in End of Life Care: Insights from Two Collaboratives." Joint Commission Journal on Quality Improvement. 26.5 (May 2000): 254-267.


Advance Directives


Model Policy for DNR Orders in Dialysis Facilities - developed by the ESRD Peer Workgroup of the Robert Wood Johnson Foundation Promoting Excellence in End-of-Life Care Program and endorsed by the RPA/ASN Quality Patient Care Committee.

State-specific advance directive documents - provided by the National Hospice and Palliative Care Organization (NHPCO).

10 Legal Myths about Advance Medical Directives - specific laws about advance directives and healthcare proxy, from the American Bar Association's Commission on Law and Aging.

Patient Self Determination Act - get information on the federal law requiring hospitals, nursing homes, home health agencies, and HMOs to provide information on advance directives at the time of admission (from the American Bar Association's Commission on Law and Aging).

Five Wishes - this document, available in print, video, and DVD (English and Spanish) from Aging with Dignity, helps you express how you want to be treated if you are seriously ill and unable to speak for yourself.

Briggs, Linda A., Karin T. Kirchhoff, Bernard J. Hammes, Mi-Kyung Song, Elaine R. Colvin. "Patient-centered advance care planning in special patient populations: A pilot study." Journal of Professional Nursing. 20.1 (Jan 2004): 47-58.

Advance Care Planning: For the Dialysis Patient and their Family
- This brochure was developed by the Mid-Atlantic Renal Coalition and the Academy for Educational Development, with funding by CMS, to serve as a guide for patients and their families as they discuss options for future care. If you would like copies of the brochure, download an order form for the Advance Care Planning brochure and submit it to the Network office.


Hospice & Palliative Care


DyingWell.org - resources for people facing life-limiting illness, their families, and their professional caregivers.

National Hospice and Palliative Care Organization (NHPCO) - the oldest and largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end-of-life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for people dying in America and their loved ones.

Hospice Foundation of America - provides leadership in the development and application of hospice and its philosophy of care with the goal of enhancing the American health care system and the role of hospice within it.

Medicare Hospice Benefits - this is the official government publication for Medicare benefits with important information about eligibility, benefits, locating a hospice program, and more.

Brody, Jane E. "Facing Up to the Inevitable, in Search of a Good Death." The New York Times. 30 Dec 2003. 2 Nov 2004 http://www.nytimes.com.




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