Phase 5 – Growing the Palliative Care Program

MOU

• Example SNGRT MOU (PDF)

Hospital Discharge Planning

• Care Plan Template (MS Word)
• Checklist Template (MS Word)
• Hospital Discharge Planning Description Template (MS Word)
• Example Hospital Discharge Planning Remote Communities Power Point Presentation (PDF)

HSIP Proposal

• NFN Wisokotaatiwin HSIP Proposal (PDF)

Journey Mapping

• Conducting Journey Mapping to Create a Palliative Care Pathway for First Nations Communities: A Step by Step Guide (PDF)
• Leadership Team Meeting 1 Sample Agenda Template (MS Word)
• Nine Stage Palliative Care Pathway Diagram Template (MS Word)
• Journey Mapping Workshop 1 Sample Agenda Template (MS Word)
• Documenting the Current State Worksheet Template (MS Word)
• Leadership Team Meeting 2 Sample Agenda Template (MS Word)
• Implementing the Palliative Care Pathway Worksheet Template (MS Word)
• Journey Mapping Workshop 2 Sample Agenda Template (MS Word)
• Leadership Team Meeting 3 Sample Agenda Template (MS Word)
• Implementing the Palliative Care Pathway Action Plan Worksheet Template (MS Word)
• Journey Mapping Workshop 3 Sample Agenda Template (MS Word)
• Evaluating the Palliative Care Pathway Worksheet Template (MS Word)

Palliative Care for Front Line Workers in First Nation Communities

• PCFN Module 1 Creating Context template (MS PowerPoint)
• PCFN Module 2 Working with Families template (MS PowerPoint)
• PCFN Module 3 Pain Symptom Management template (MS PowerPoint)
• PCFN Module 4 When the Time is Near template (MS PowerPoint)
• PCFN Module 5 Grief and Bereavement template (MS PowerPoint)
• PCFN Module 6 Helping Relationships template (MS PowerPoint)
• PCFN Module 7 Community Care Teams template (MS PowerPoint)

Finding Our Way Through Navigating Loss and Grief in First Nation Life

• Example EOLFN Grief and Loss Manual (PDF)
• Example EOLFN Grief and Loss Power Point (MS PowerPoint)

Palliative Care in First Nations Community Brochures

• What is Palliative Care template (MS Word)
• Example EOLFN What is Palliative Care (PDF)
• Living with a Terminal Illness template (MS Word)
• Example EOLFN Living with a Terminal Illness (PDF)
• Caring for Someone with a Terminal Illness Care for the Caregiver template (MS Word)
• Example EOLFN Caring for Someone with a Terminal Illness Care for the Caregiver (PDF)
• Caring for Someone with a Terminal Illness What to Expect template (MS Word)
• Example EOLFN Caring for Someone with a Terminal Illness What to Expect (PDF)
• Supporting the Caregiver and the Family template (MS Word)
• Example EOLFN Supporting the Caregiver and the Family (PDF)

Palliative Care Community Awareness Sessions

• Example FWFN Palliative Care Community Awareness Sessions Poster (PDF)

Advance Care Planning

• ACP Pamphlet Publisher template (Compressed PUB)
• ACP Pamphlet word template (MS Word)
• Example EOLFN ACP Pamphlet (PDF)
• SDM Pamphlet Publisher template (Compressed PUB)
• SDM Pamplet word template (MS Word)
• Example EOLFN SDM Pamphlet (PDF)
• ACP Poster word template (MS Word)
• Example EOLFN ACP Poster (PDF)
• Example EOLFN ACP Presentation Facilitators Guide (PDF)
• Example EOLFN ACP Power Point Presentation (MS PowerPoint)
• ACP Power Point Presentation template (MS PowerPoint)
• Example FWFN ACP Presentation (PDF)
• Example SNGRT ACP Brochure (PDF)
• Example SNGRT ACP Presentation (PDF)
• The Time is Now Advance Care Planning for First Nations People Video
  • Right click the video link and choose ‘Save Link As’ to download the video.
  • (HD video – 75mb)
  • (SD video – 42mb)

Cultural Sensitivity Resources

• Example NFN Cultural Sensitivity Workshop Participant Evaluation Survey (PDF)

Naotkamegwanning Wiisokotaatiwin Program

• Client Referral Intake Form template (MS Word)
• Client Program Assessment Form template (MS Word)
• Program Care Plan Form template (MS Word)
• Program Checklist for Home Passing template (MS Word)
• Example NFN Client Brochure (PDF)
• Example Palliative Performance Scale (PDF)
• Example NFN Wiisokotaatiwin Program Assessment Form (PDF)
• Example NFN Wiisokotaatiwin Program Care Plan Form (PDF)
• Example NFN Wiisokotaatiwin Program Checklist for Home Passing (PDF)
• Example NFN Wiisokotaatwin Client Referral Intake Form (PDF)

Six Nations Shared Care Outreach Team

• Example SNGRT Shared Care Outreach Team Care Pathway (PDF)
• Example SNGRT Shared Care Outreach Team Description of Workplan (PDF)