The Northeast Kingdom Palliative Care Initiative

At North Country Health System we recognize that care of the dying is an important part of health care. Death is a part of life and there is a need to enhance the quality of life when death is approaching and the quality of dying when death is imminent. Care of the dying is called palliative care.

The Northeast Kingdom Palliative Care Initiative (NEKPCI) is a coalition of community members and health care providers working to build a community-based model of end of life care that improves care for the dying through education, communication and institutional change.

Mission & Vision
The mission of the NEKPCI is to create a seamless system of care for all individuals on their end of life journey, no matter where that journey takes place in our community. This system incorporates a hospice-like philosophy and promotes a community standard of care for pain control, emotional support and spiritual support. NEKPCI’s vision is that all local community health care facilities and agencies will care for the dying in a way that eases suffering, promotes choices, and provides comfort to loved ones.

Brief History/ Membership
Originally founded in 1997 under a prior name, NEKPCI was subsequently “re-born” as a coalition of health care providers and community members for the purpose of improving the care of the dying in this area.

Membership includes:

• North Country Hospital
• Orleans Essex Visiting Nurse Association & Hospice, Inc.
• Local clergy, health care providers and community members
• The five area skilled nursing facilities:
  • Bel-Aire Quality Care Nursing Center (Newport)
  • Derby Green Nursing Facility (Derby)
  • Maple Lane Nursing Home (Barton)
  • Newport Health Care & Rehabilitation Center (Newport)
  • Union House Nursing Home (Glover)

Members meet monthly as a planning council and have participated in the coalition since its inception, supporting it directly and in kind. Monthly meetings focus on program development, planning educational forums, reviewing progress, assessing community needs and reporting on institutional initiatives.

In autumn of 2002, the coalition elected to incorporate as a separate non-profit corporation and as such received a provisional 501(c)(3) status in October 2003. The corporation is under the leadership of its Board of Directors which meets quarterly and consists of representatives of the above groups. The Board Chairperson is Dr. Denise Niemira, a community physician. NEKPCI is headquartered at her office at Family Medicine, 5452 US RT 5, Suite D, Newport, VT 05855.

Goals / Outcomes
NEKPCI focuses on the goals of:

• Education
  • Providing education to professional and paraprofessional caregivers in state of the art palliative care
  • Providing education to community members in end of life care resources and programs available locally
• Communication
  • Serving as a forum for communication among the participating organizations / institutions to provide seamless transitions (if transitions must occur) in the provision of optimal end of life care
  • Serving as a conduit of community feedback on experience with end of life care to health care providers and institutions
• Institutional Change
  • Collaboration and commitment among participating health care organizations /institutions to create a climate of supportive care for the dying and their families that recognizes choices and incorporates the highest standards of compassion and quality.

With its focus on the above goals, NEKPCI has already:

• Created a common set of palliative care orders among member institutions and providers in the North Country Hospital service area
• Standardized palliative nursing care plans
• Generated a volunteer program for respite and music volunteers to provide services in the skilled nursing facilities as hospice volunteers do in the home
• Transformed the Hospice Memorial Service into an annual Community Memorial Service
• Instituted a common approach to the delivery of palliative care in the member institutions through the use of the palliative care cart
  

Overall, NEKPCI looks forward to a greater community awareness and understanding of palliative care and bereavement services as well as the creation of a sustainable culture of caring for those at the end of life that embodies the highest standards of excellence.

Recognitions
The NEKPCI was selected as a Spotlight on Improvement by the Vermont Program for Quality in Health Care and is included as such in its Quality Report 2003. The report, entitled Integrating Palliative Care into the Rural Community, and authored by Dr. Denise Niemira, describes the NEKPCI experience, including activities, outcomes and future plans.

Palliative Care at North Country Hospital
At North Country Hospital, the team of palliative care providers includes healthcare professionals, clergy and community volunteers working together to provide quality end of life care. A patient-driven plan of care includes among its priorities optimal pain and symptom management. The plan of care also includes working very closely with family members and collaborating with other community entities in order to provide optimal support, including spiritual support, for the patient and family, as well as the most appropriate physical environment.

Improving end of life care by treating the dying with dignity and compassion while honoring family cultures, and caring for those left behind benefits the entire North Country community since everyone must at some point face the loss of a loved one.

Options in Palliative Care at North Country Hospital include:

Palliative Care Cart
(With cassette player & tapes, lotions, aromatherapy,
inspirational books, religious articles)
Private Room -- Special Indirect Lighting
Accommodations for Family Stays
Volunteers Providing Respite Care
Music Therapy
Spiritual Support
Complimentary Personal Care Items for Family
(Such as beverages and meal trays)
Special Gifts
(Such as Palliative Care Bear,
Journal entitled “A Loved One’s End of Life Journey”, Camera)

Families are encouraged to communicate their special requests or needs. The palliative care team tries to accommodate such requests as much as possible.

For more information about end of life care and related topics, please visit our Health Links.

For more information about Palliative Care in the North Country Hospital service area,
Contact Denise A. Niemira, MD, Chairperson of the NEKPCI,
802-334-6140 or e-mail denise@nekpci.org
or visit www.nekpci.org