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New Guidance for Healthcare Professionals Dealing with Dying Patients

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New advice has been issued to help health and social care workers deliver “a good death” for patients who are dying.

 

The National Institute for Health and Care Excellence (NICE) recommend personalised plans for the dying that take into consideration their wishes and those of their family in a bid to reduce unnecessary suffering.

A former end-of-life protocol was scrapped last year after an independent review of the process found serious failings in the way that is was used by staff, who were found to be failing to recognise when patients were in the least days of their lives.

Managing Common Symptoms

The new guidelines cover the clinical care of adults (aged 18 years and over) and detail how to manage common symptoms without causing unacceptable side effects and maintain a person’s hydration in the last days of life.

The guidelines acknowledge that the ways in which people die and how long this takes does vary, according to the underlying disease responsible and also the person’s robustness or frailty and the social setting they are in. The guideline focuses on all people at the end of their life, whether they are conscious or not.

It replaces the Liverpool Care Pathway for the Care of the Dying Adult – a protocol that was found to have three main areas of concern, thanks to poor or indiscriminate implementation and a lack of staff training and supervision. Poor use of the LCP had often left patients dehydrated and desperate for a drink, or not given the medications to help manage their symptoms which led to suffering.

Recognition of Approaching Death

The new guidelines recommend: recognising when someone could be in the last days of their life, communication, shared decision-making, maintaining someone’s hydration, pharmacological interventions and anticipatory prescribing (for symptom control).

As recognition of when someone is entering the last days of their life is difficult, the guidance sets out what information should be recorded and what signs healthcare professionals should look out for which may indicate if someone is deteriorating or recovering.

NICE deputy chief executive Professor Gillian Leng said she knew that the vast majority of people in the UK received very good end-of-life care, but that it wasn’t always the case.

Professor of palliative medicine and chair of the independent committee that created the guidelines, Professor Sam Ahmedzai, said the LCP’s implementation had become controversial over the last few years with incidents where fluids and medicines had been withheld and the dying person had been over-sedated.

You can read the full NICE report here.

Finders International assists councils, coroners, hospitals and other public sector service providers free of charge by identifying and tracing next of kin to people who have died in hospitals or care homes without any apparent next of kin.

We can also verify the identity and relationships of those claiming to be next of kin and we are usually able to trace the first next of kin within 24 hours – often in time for the person’s funeral. Find out more about our services here.