Caring for Adult Patients in the Lastfew Days of Life

Caring for adult patients in the lastfew days of life

Ensuring that care is focused on patients and families so that individualised care is timely, supportive and includes robust communication to both patients and their significant others in the patients’ last few days of life.

Dear Colleague

Following thelaunch across LPT on new guidancefor caring for adult patients in the last few days of life, the recommendations, authorisations and requirements outlined in these documents went live 6 October 2014. This needs to be part of your day-to-day compulsory practice to ensure patient centred care for all our patients and those identified as important to the patient in their last days of life.

If you haven’t already done so, it is important that this documentation is appliedfor all cases that involve caring for adults in the last few days of life.

In addition to the new documentation, we have ensured the EOLC template on SystmOnewill enableall staff to keep a record of patients receiving care in the last few days of life.

What to do next

Please refer to information you received Aug/Sept 2014 whenCaring for adult patients in the last days of life compulsory training sessions were rolled out prior to thenew documentation launch. Details of this documentation, drug authorisation forms and web links are given on page2 of this sheet.

Background

The ‘Liverpool Care Pathway’was discontinued and replaced with new documentation developed by LPT in partnership with the clinical commissioning groupsLOROS and UHL.

TheNHS’s Leadership Alliance for the Care of Dying People isvery clear that there must be improvement in people’s experience of care in the last days and hours of life and has developed prompts for practice to ensure that all health and care staff are aware of their duties and responsibilities.

The five key priorities are:

1. Recognising the possibility that a person may die within the next few days or hours. The patient must be seen by a doctorwho can assess if the patient’s condition is potentially reversible or they are likely to die in the next few hours. In community hospitals the ANP will often be the first contact for recognising and assessing this but they will discuss with the geriatrician for ongoing support and advice.

1. Communication must take place with the patient and their family/those identified as important to the patient.

1. Involving the patient and family/those identified as important to the patient in decisions about treatment and care.

1. Supporting the needs of the family/those identified as important at this distressing time.

1. Plan and Do – everyone should have an Individualised Plan of Care for symptom control, psychological, social and spiritual support. It should also include discussions on food and drink. This should be agreed, co-ordinated and delivered with compassion by all health and care services.

Documents/links

The following documents can be accessed on e-Source and are listed under the page heading: Caring for adults in the last few days of life If you have problems accessing this link, log into eSource and go to the knowledge and development area. Caring for patients in the last few days of life can be found on the left hand side of the menu tree

The document: Individualised care plan for patients in their last days of life provides documentation and a prompt sheet to be used with patients to ensure quality individualised care and gives guidance on caring for patients in the last days of life.

Care in the last days of life - a document to support staff

This document provides guidance to ensure that the care of the adult patient in their last days of life is personalised, reflects their individual needs and preferences and that attention is paid to assessing and addressing physical (including symptoms, hydration and nutrition, and skin and mouth care), emotional, psychological, social and spiritual needs of that individual, as well as his/her personal care needs and sense of dignity.

Authorisation forms for PRN medications and syringe driver medicationsYou can access authorisations for pre-emptive palliative care drugs for your patients. The webpage also includes other leaflets and supportive information for you.

Recording on SystmOne

If you commence a patient onLast few days of life documentation

Please complete the EOLC template ‘NewVersion’

Care in last days of life coding (Final Days Pathway) has been added.The highlighted areas (below)must be completed to ensure that the event is recorded on SystmOne.

For further information please contact: or .