Comfort Measures

Comfort Measures 

Goal 
To promote quality of life and physical and emotional comfort at a time when treatment aimed at cure is no longer realistic or appropriate. 

Policy 
The resident, responsible party, and/or family will participate with the physician and the interdisciplinary team in developing the most appropriate treatment plan for the resident. The focus of a comfort measures treatment plan is providing individualized, comfort-oriented palliative health care without pursuing aggressive treatment such as CPR, surgery, IV therapies, and diagnostic testing. 

Procedure 

1. Review of Condition and Options: 

• The resident’s condition and treatment options will be reviewed with the resident and/or responsible party by the physician in collaboration with the interdisciplinary team. This discussion is to be documented in the resident’s medical record. 

2. Review and Adjustment of Medical Orders: 

• The resident’s current medical orders will be reviewed. Medications, treatments, and diagnostic tests that are not deemed necessary for the comfort of the resident may be discontinued. 

3. Plan of Care: 

• The resident’s plan of care will be reviewed and revised to reflect the resident’s and/or responsible party’s goals for palliative care. Interventions that are not deemed necessary for the comfort of the resident may be discontinued. 

• The plan of care will include interventions developed to promote pain management and to address the actual and/or potential physical, emotional, and spiritual comfort needs of the resident. 

4. Interdisciplinary Team Involvement: 

• The interdisciplinary team, including nursing, social work, chaplaincy, and other relevant professionals, will collaborate to ensure that the resident’s comfort needs are met holistically. 

5. Documentation: 

• All discussions, reviews, and changes to the treatment plan must be thoroughly documented in the resident’s medical record. This includes the rationale for discontinuing any treatments and the specific comfort measures to be implemented. 

6. Ongoing Assessment: 

• The resident’s comfort and overall condition will be continuously monitored and assessed by the care team. Adjustments to the plan of care will be made as necessary to ensure optimal comfort. 

References: 

• Centers for Medicare & Medicaid Services (CMS), State Operations Manual (SOM) 

• Requirements of Participation for Nursing Homes, CMS 

• Palliative Care Guidelines, National Hospice and Palliative Care Organization (NHPCO)