Developing an End-of-Life Program for Long Term Care Residents

摘要

Background: An end-of-life program, the Butterflies Are Free Program, was developed at Life Care Center, a long term care facility in Sarasota, Florida, to provide residents with comfort and dignity during the end stage of life. PI Team: A PI team identified the goal: "Establish an end-of-life program that maintains comfort and dignity for the resident involving the family, residents, and staff in the plan of care at their personal level of comfort. The end-of-life program should put no financial strain on the family." The program entailed involving the resident and family in the end-of-life care plan, which included con- sideration, for example, of pain medications, spiritual support, and continuing or discontinuing routine med-ications. The project team began meeting in August 2002, and the program was formally implemented in December 2002. Results: A preintervention (control group), which covered 11 months, was compared with a 2003 postin-tervention group, which covered 13 months. Data indi- cated that the number of residents receiving pain medication during the dying process increased by 27.3%. The facility team members received thank you notes and cards from 41% of the families whose loved one died. The initiative reduced the out-of-pocket expenses to the dying resident and their family by 48%. Discussion: Review of the 2003 data prompted the development of new goals for 2004 and a refinement of the end-of-life program. This program could be easily duplicated in any long term care facility.