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End of Life Care

People who are approaching the end of their life are entitled to high-quality care, wherever they're being cared for.

Good end of life care is tailored to the person who needs it. You and the people close to you should be at the centre of decisions about your care.

It helps if your wishes are written down as a personalised care plan and, if you agree, that this can be shared with the people involved in your care now and in the future. It's important your care plan is reviewed regularly so that it stays up to date as your situation and wishes change.

The staff caring for you should show respect for you and behave kindly. Your comfort and dignity are important. That means, for example, that in the last days of life you can decide whether you feel like eating and drinking rather than a focus on a feeding tube or a drip..

5 priorities for care of the dying person’

Experts have agreed that there are 5 important priorities for the care and support that you and your carers can expect to receive in the last few days and hours of life:

  • You should be seen by a doctor regularly and if they believe you will die very soon, they must explain this to you and the people close to you.
  • The staff involved in your care should talk sensitively and honestly to you and the people close to you.
  • You and the people close to you should be involved in decisions about how you are treated and cared for, if this is what you want.
  • The needs of your family and other people close to you should be met as far as possible.
  • An individual plan of care should be agreed with you and delivered with compassion.

What is palliative care?

If you have an illness that cannot be cured, palliative care makes you as comfortable as possible by managing your pain and other distressing symptoms. It also involves psychological, social and spiritual support for you and your family or carers. This is called a holistic approach, because it deals with you as a "whole" person, not just your illness or symptoms.

Palliative care is available when you first learn you have a life-limiting (terminal) illness. You might be able to receive palliative care while you are still receiving other therapies to treat your condition.

End of life care is a form of palliative care you receive when you're closer to the end of life

Adopting a palliative approach will usually involve stopping treatments that are no longer benefiting the patient and avoiding procedures that cause unnecessary discomfort or distress. High quality, patient centred care will continue but the focus will be on respecting the dying patient’s wishes and maintaining their comfort & dignity.

Additional support from the hospital’s palliative care team will be offered as appropriate.

 

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External Article: About End of Life in Intensive Care information sheet: ICU Steps

The story behind ICUsteps' newest information sheet - Catherine White

Form: Bereavement support

Bereavement is the experience of losing someone important to us and grief is the process and range of emotions felt as someone comes to terms with the death of a loved one. Bereavement, grief and loss can cause many different symptoms and affects people in different ways. Experts generally accept that we go through 5 stages of bereavement or grief: Denial – feelings of shock, disbelief, panic or confusion Anger – feelings and behaviours such as blaming yourself or...

Document: Bereavement support at Guy's and St Thomas's Hospital

This leaflet is about some of the emotions you may feel when someone close to you has died. It also has details of other organisations that offer support.

Web Link: End-of-life care: what it involves and when it starts? NHS weblink

NHS weblink on end-of-life care for all patients, but helpful information for those cared for in ICU.

Web Link: End-of-life in intensive care: ICU Steps information

This information explains what may happend at the end of someone's life in an intensive care unit. It explains about the care and support given, including what people may experience in the last hours or days of their life.

Web Link: Finding bereavement support services:

This link will help you find bereavement support services in your local area.

Web Link: Guy's and St. Thomas' Palliative Care Service

Additional support from the hospital’s palliative care team will be offered as appropriate. Details are found here.

Web Link: https://www.goodlifedeathgrief.org.uk/content/support/

where to go for support There are a range of organisations that can help provide information and support to people who are personally affected by death, dying and bereavement: Before a death After a death Support for carers Advice for professionals There are certain practical steps that everyone can take when thinking about planning for the future. More information about planning ahead for illness and death is available here: Planning for the future

Document: What should I do now? After a loved one has died. Guy's and St Thomas's leaflet

Document: What to expect when someone is dying.

What to expect when someone is dying A guide for relatives and friends This information is useful if your relative or friend is very unwell and may die in the coming hours or days. This information describes some of the changes that can occur when someone is at the end of their life. Please speak to the medical team if you have questions or concerns.

  • Supported by - GSTT Charity
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  • Critical Care Recovery