The ABCs of End of Life Care
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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:

A: Ask 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;

A: Assess 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;

B: Believe the resident's report of pain or other symptoms, what precipitates it or makes it worse, and what relieves it;

C: Choose symptom control options that are appropriate for the resident;

D: Deliver interventions in a timely, logical and coordinated manner;

E: Empower the resident to participate in defining the goals of treatment and planning the interventions to the extent possible; and

E: Evaluate the effectiveness of the chosen interventions.

Source: 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).


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