End of life care helps those nearing the end of their lives to feel as comfortable and supported as possible. They’ll receive a mix of physical and emotional care, helping to maintain their mental and physical health. In the last stages of life, it’s vital that individuals are treated with dignity and respect.
There is no definitive answer for when end of life care needs to start. Some people will receive this type of care when they only have a few days of life left, whereas others with a terminal illness can receive end of life care for months or years. It all comes down to the individual and their personal preferences. Being cared for in a safe, relaxing environment, rather than a hospital, is often preferred by those with terminal illnesses.
End of life care is a person-centred approach, which focuses on putting the wishes of the individual first. Therefore, this type of care can be discussed whenever someone feels ready for it.
For those who no longer have the capacity to make decisions themselves, someone with power of attorney can make arrangements on their behalf.
There are six different stages within the end of life care pathway, which can be tailored to suit the needs and wishes of the individual.
The end of life pathway was designed to help guide care practitioners through someone’s final stages of life. The aim is to provide individuals with a plan that will offer the best quality of life possible to those being cared for.
During this stage, open discussions are held with the individual and their family around what end of life care will involve and any preferences which they may have. It’s vital that this type of care is given in a way which is appropriate for that individual, which is why honest communication is key.
Of course, discussions around death can be very difficult to face. It can take time for people to come to terms with this stage of life and some people may not wish to discuss it at all. If this is the case, their decision should be respected and conversation shouldn’t be forced. However, if the patient or their family do have particular, appropriate preferences, then every effort should be made to fulfill these.
An agreed care plan will be introduced based on medical requirements and a holistic assessment of the individual’s wellbeing. This holistic method of examination should help to understand a range of physical, psychological, emotional, environmental and spiritual needs.
Naturally, this care plan won’t be fixed in place and will change along with the individual’s condition and preferences. For this reason, regular review sessions will take place to ensure that the assessment plan is still appropriate.
At this stage of the pathway, the needs of the carer are also assessed, making sure that they’ll be able to provide the level of care required.
After a care plan has been created, this needs to be coordinated with the relevant healthcare services. Some people may require services from a range of different settings, including a care home, hospital, hospice and ambulance transport.
Care plans may also need to be coordinated across the care home team. It’s vital that all relevant members of staff are aware of the current care plans in place and are able to communicate between themselves.
Quite simply, high-quality care should be provided to those receiving end of life care, no matter which setting they choose to be in. If high-quality care is provided, hospital admission and stressful situations can potentially be avoided.
All care settings should use their resources to the best of their ability, ensuring that individuals are provided with the right physical and mental care. From comfort measures, to the prescribing of medication, each setting will have complex strategies in place to keep each person as content as possible.
Once it’s been identified that an individual is in their final days, their needs will be reviewed again. This can, of course, be a very emotional and difficult time for both the person and their family. For this reason, every effort must be taken to comfort and help bring a sense of calm.
For those in their final days, spiritual requirements can rise in importance. The person may wish to speak with someone from their religious community or to have prayers recited. Alternatively, some people may wish to speak or be with their family, who can help them to feel less alone.
In addition, wishes around resuscitation, organ donation and place of death should be respected too.
End of life care doesn’t stop after an individual has passed away. The attention can now turn to providing the family with appropriate emotional and bereavement support. Each person will deal with death in a different way and this must be respected. Some people may wish to spend some time alone, whilst others may wish to speak with someone about their feelings.
The individual’s time of death will also need to be recorded and verified and a certification of death will be provided by a doctor.