Nursing Home Tools and Resources

Palliative Medicine & End-Of-Life Care In Nursing Homes

CARE Recommendations:
Compassion And Respect toward the End of life [PDF]

Steps and Tools to Implement Palliative Care in Nursing Homes

Death may be a natural part of life, but talking about it in our culture isn’t—and this is clearly true for those of us who work in nursing homes. Although nursing home residents do die, few nursing homes have established customs and practices to provide guidance in caring for residents and talking with families about the final phase of a resident’s life.

Download CARE Recommendations and learn how to:

  • Facilitate conversations with residents and family members to clarify goals of care in light of the individual resident’s specific preferences.
  • Provide care that addresses residents’ physical needs, while also honoring their emotional, psycho-social, and spiritual needs.
  • Establish processes and rituals that acknowledge the sacredness of the human spirit in residents, staff and family members.
  • Create a culture in which resident’s individual needs and preferences are known and honored.

View the CARE Toolkit

Download the original CARE Recommendations, published in February 2010 [PDF].

POLST Resources


Designed to provide skilled nursing facilities with useful, QAPI-based tools which can be used to improve POLST utilization in California’s nursing homes and assure that residents’ end-of-life treatment wishes are understood, documented and followed.
Download the QAPI Toolkit as a PDF

POLST Model Policy for Skilled Nursing Facilities PDF / DOC

POLST Cover Sheet PDF

Other Resources…

Preparing Residents for End-Of-Life Plans and Respecting End-Of-Life Decisions

In 2007, CCCC’s PREPARED project established collaboration between four hospital systems and 18 Sacramento-area nursing homes to improve advance care planning and reduce unnecessary transfers for residents with advanced chronic illnesses.

As a direct result of the project, over 1,000 nursing home staff were educated on end-of-life issues, goals of care, symptom management and advance care planning. Key nursing home staff received mentoring and role modeling in facilitating advance care planning discussions with nursing home residents and family members.

ECHO Nursing Home Recommendations [PDF]
Recommendations for Improving End-of-Life Care for Persons Residing in California Skilled Nursing and Intermediate Care Facilities
January 2000

The purpose of these recommendations is to facilitate institutional processes, enhance provider competence and strengthen organizational relationships to improve two broad domains of end-of-life care:

  • Advance care planning: The process of identifying the resident’s personal perspectives and values, which – in conjunction with the resident’s current and anticipated medical status – provide the basis for making end-of-life medical decisions.
  • Palliative care services: Services that provide physical, emotional, psychological, social and spiritual comfort and that together compose appropriate care of the dying person.

Promising Practices to Improve End-of-Life Care in California [PDF]

In 2002, CCCC worked with a small group of California nursing facilities that were excelling in various aspects of end-of-life care for a project called the Promising Practices Initiative.

The Initiative developed technical assistance and mentoring to refine these practices into replicable models that were adopted by other nursing facilities at the state and national levels. Learn more about these models.

Learn more about how CCCC promotes quality, compassionate care for California’s nursing home residents.