New CARF accreditation standards address palliative and end-of-life care

CARF International developed, and will release by mid-January, interdisciplinary, field-driven accreditation standards for Palliative and End-of-Life Care (PELC). The accreditation standards demonstrate a person- and family-centered approach to providing holistic support to individuals who are experiencing life-limiting conditions and illness.

Early integration of palliative care allows a program to address the cultural, physical, emotional, psychosocial, religious, and spiritual needs and preferences of the persons served. The program seeks to understand the values, beliefs, wishes, and end-of-life choices of the person served through advance care planning and implementation of individualized, interdisciplinary care plans.

“As the world’s population continues to age, we will see an increase in the need for these programs. CARF accreditation, led by peer surveyors, will assure the public that these accredited programs are held to the highest standards of quality and performance improvement in the specialty of PELC,” said Terrence Carolan, CARF managing director of Aging Services and Medical Rehabilitation.

The PELC specialty program provides or arranges for grief and bereavement supports/resources and end-of-life care. The program educates providers across the continuum of care and advocates for underserved populations. It utilizes current research and evidence-based practices to provide effective care and support to persons served and their families/support systems. The program demonstrates the commitment, capabilities, and resources to comprehensively address the complex needs of persons with life-limiting illness across a variety of settings.

CARF developed these standards as a resource to aging services providers and community stakeholders. Key areas of the standards include:

• Philosophy of palliative care
• Early integration
• Advance care planning for each person served
• Education that meets the needs of persons served and families/support systems
• Grief and bereavement supports and resources
• Holistic end-of-life support
• Competency-based training for personnel, including volunteers
• Ethical concerns related to palliative and end-of-life care situations
• Policy on medical assistance in dying

Accreditation for PELC demonstrates a program’s capability of addressing the diverse and potentially complex health needs of individuals with life-limiting illness and provides integrated, evidence-based, person-centered care.  

The standards are published in the 2025 standards manuals for Aging Services and Continuing Care Retirement Communities, and accreditation surveys using the standards begin July 1, 2025. CARF’s standards introduce an established, international mechanism to share and adopt best practices to improve outcomes. Accreditation demonstrates to persons served, regulators, and payers that the organization offers a comprehensive array of services and supports designed to help persons served.

“The field of PELC continues to evolve rapidly, and using CARF’s field-driven standards to achieve accreditation ensures that individuals with life-limiting illness are receiving evidence-based care from an interdisciplinary team at the time when it is needed most,” said Carolan.

CARF’s process for creating new standards includes convening an International Standards Advisory Committee (ISAC) to develop the standards, then a review of the proposed standards and gaining expert insight from the International Advisory Council before conducting a public field review. The Palliative and End-of-Life Care ISAC and public field review involved 55 stakeholders, including individuals with lived experience and their family members.