End of Life Care Phases Advance Care Plan Record 1 2 3 4 5 Assessment on the Review Review Review Review North Date date date– date– date– – West Model completed Key worker record any record any record any record any Advancing Increasing Post Follow up Last days above or declined change change change change bereavement disease decline of life Resident’s Date support Name given Supportive Care Record V2 2014
End of Life Care Phases Advance Care Plan Record Assessment on the North West Model above 1 Advancing disease 2 Increasing decline 3 Last days of life 4 Post bereavement support given 5 Follow up Date completed or declined Review date – record any change Review date– record any change Review date– record any change Review date– record any change Key worker Resident’s Name Date Supportive Care Record V2 2014
10._Six_Steps_Care_Homes_Step_1_Supportive_Care_record_with_dates.docx