Quarterly Risk Management Tip
The ABCs of End of Life Care
According to the Centers for Medicare and Medicaid Services, the following mnemonic (ABCDE) will help staff to better manage a resident's symptoms, as well as meet their physical and emotional needs at the end of life:
the resident or his or her legal representative about (and screen for) pain and other symptoms related to their end of life status on admission and periodically;
regularly and systematically for symptoms (such as dyspnea, fatigue, declining function, anorexia/eating difficulties/weight loss, pain, loneliness, anxiety/apprehension, depression, constipation and delirium) and their impact on the resident;
the resident's report of pain or other symptoms, what precipitates it or makes it worse, and what relieves it;
symptom control options that are appropriate for the resident;
interventions in a timely, logical and coordinated manner;
the resident to participate in defining the goals of treatment and planning the interventions to the extent possible; and
the effectiveness of the chosen interventions.
: Centers for Medicare & Medicaid Services, Survey and Certification Memo, Ref: S&C 12-48-NH (originally from Agency for Health Care Policy and research, 1994, Clinical Practice Guideline No. 9: Management of Cancer Pain).