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COMMISSION FINAL REPORT

 TABLE OF CONTENTS

Download the MN Commission on End of Life Care Final Report
Final Report Table of Contents
 Five Guiding Principles

 

 

THE MINNESOTA COMMISSION ON END OF LIFE CARE REPORT (PDF VERSION)

Click here to be directed to the pdf version of the Commission Final Report

 

 

THE MINNESOTA COMMISSION ON END OF LIFE CARE FINAL REPORT

TABLE OF CONTENTS

  1. Forward by Commissioner Jan Malcolm
  2. Executive Summary
  3. Minnesota Commission on End of Life Care: Background, Statistics and History

GUIDING PRINCIPLES FOR END OF LIFE CARE
  1. Statement of the Guiding Principles of End of Life Care

INTRODUCTION TO THE RECOMMENDATION SECTIONS
  1. Introduction to the Recommendations Sections

ACCESS TO END OF LIFE CARE AND SERVICES RECOMMENDATIONS
  1. Accessing End of Life Care and Services: Pediatrics
  2. Accessing End of Life Care and Services: Rural Access
  3. Accessing End of Life Care and Services: Minority and Immigrant Populations

END OF LIFE EDUCATION RECOMMENDATIONS
  1. End of Life Education

END OF LIFE CARE PUBLIC POLICY RECOMMENDATIONS
  1. End of Life Care Public Policy: Residential End of Life Services 
  2. End of Life Care Public Policy: Out-of-Hospital End of Life Care by Emergency Medical Services (EMS)
  3. End of Life Care Public Policy: End of Life Care Decision-Making for Persons Without Designated Decision-Makers – Adult Orphans

LOOKING AHEAD
  1. Next Steps

REFERENCES AND RESOURCES
  1. References
  2. Web Directory
  3. Glossary of End of Life Terms

APPENDICES

Appendix 1: The Commission on End of Life Care Organizations and Members
Appendix 2: Other Issues
Appendix 3: Acknowledgements – Assistance and Input
Appendix 4: Letter to the National Hospice and Palliative Care Organization
Appendix 5: Patterns and Trends in Dying in Minnesota

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FIVE GUIDING PRINCIPLES

Compassionate and competent care will be available,
understandable, and accessible to all who are at the end of life.

The diversity of cultural, spiritual, and religious
beliefs will be treated with respect and sensitivity.

  1. Preference for treatment and care will be discussed and respected.

Individuals and their families can expect:

    • To be informed of choices and options, to be listened to with compassion, and
      to participate in decisions about care.
    • To have questions answered in a way that can be understood.
    • To have a written plan of care with specified health care directives respected.

To make the above possible, providers (such as physicians, nurses, hospitals, nursing homes, hospices, home care agencies, and all health care providers and organizations) should:

    • Ask about goals and preferences.
    • Include individuals and their loved ones in the care decision process, whenever possible.
    • Provide assistance and resources to formulate advance care plans.
    • Honor written health care directives.
  1. Every reasonable effort will be made to relieve pain and other undesirable physical symptoms.

Individuals and their families can expect:

  • Reports of pain and other symptoms to be believed.
  • Informed, competent, and compassionate pain and other symptom relief.
  • Severe symptoms such as pain and / or breathlessness to be treated in an urgent manner.

Providers should:

  • Use available tools to assess pain and believe reports of distress.
  • Make reasonable efforts to anticipate, prevent, and relieve undesirable symptoms.
  • Treat severe symptoms immediately.
  1. Emotional, spiritual, and personal suffering will be identified, addressed, and discussed.

Individuals and their families can expect:

  • To be asked about and offered relief of emotional, spiritual, and personal suffering.
  • Respect for cultural and religious preferences.

Providers should:

  • Ask about emotional, spiritual, and personal suffering.
  • Offer the help of interdisciplinary and / or community resources.
  1. Appropriate and realistic information will be provided regarding prognosis and the expected course of events preceding death.

Individuals and their families can expect:

    • To be prepared for changes that are likely to occur in the course of the illness.
    • A plan to be in place for managing anticipated events.
    • To be informed about the costs of treatments and care.

Providers should:

    • Provide honest information on what is likely to happen in the course of an illness.
    • Provide guidance in planning how to handle predictable events.
    • Identify patients who are likely to die from their current illness and make a plan congruent with that outcome.
  1. Grieving will be acknowledged.

Families can expect:

  • Compassionate acknowledgment of loss in a quiet and safe place.
  • To be with the deceased loved one as long as needed / desired.
  • Compassionate recognition that grieving takes time.
  • Acknowledgement that grief and loss can begin prior to death and may continue for longer than "expected".
  • Understanding that every death and every family member’s response to that loss is unique.
  • To receive a minimum standard of bereavement follow-up after the death.

Providers should:

  • Provide a quiet and safe place for families to grieve.
  • Accommodate family wishes to be with the deceased loved one.
  • Acknowledge that grieving is a unique process with a variable time course.
  • Offer options for support for long-term grieving.
  • Acknowledge that grief and loss begin prior to death and may continue longer than "expected".
  • Provide an accepted standard of bereavement follow-up after the patient’s death.

 

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Click here to view the letters of support from the Commission on End of Life Care co-chairs and supporting organizations.

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