UK Issues Draft Guidance for Care of the Dying

end-of-life care
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The National Institute for Health and Care Excellence (NICE) has produced new draft guidance to improve the care of adults nearing the end of their lives. The guidelines have been proposed as an alternative to the controversial Liverpool Care Pathway, which was phased out in 2014 after a review by the Health Service Ombudsman found serious failings in the way it was being used.

In June last year a set of guiding principles for the care of dying people, called the Priorities for Care, was published to replace the axed care pathway.

When asked how the NICE guidance would fit in with the priorities framework, a spokeswoman for the institute said: “The framework sets out the main priorities for care and our guideline will set out best practice to support staff to achieve these.”

The new NICE guidance, which is out for consultation, includes a series of recommendations covering key areas such as the prescribing of medicines, care plans and communication, as well as hydration. For example, the guideline says end-of-life patients should be encouraged to drink “if they wish to and are able to” and, if considered beneficial, these patients should receive assisted hydration.

The document also lists signs and symptoms that may indicate death is imminent in an effort to ensure people do not miss out on treatment and care that could make their final days more comfortable.

Moreover, the new guidance stresses the need for nurses and doctors to communicate clearly with the dying person and their family and ensure they are fully involved in decisions about treatment.

Some families who contributed to the review of the Liverpool Care Pathway said their elderly relatives had been placed on the pathway without their knowledge or consent.

Multi-professional teams should create an “individualised plan of care”, which includes the dying person’s wishes, such as where they would prefer to die and how they would like symptoms to be managed.

The consultation on the draft guidance is open until 9 September, with the final document due out in December.

Medical director Professor Bill Noble welcomed the NICE guidance but said it was vital the recommendations were backed up by training for nurses, as well as other health and social care professionals. “Without this kind of training to embed the NICE guidelines, failings in care identified in the recent Health Service Ombudsman report will continue and may worsen,” the professor added.

Source: National Institute for Health and Care Excellence
Image credit: NHS, UK

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Published on : Tue, 4 Aug 2015

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healthmanagement, end of life, guidelines, death, communication, informed consent The National Institute for Health and Care Excellence (NICE) has produced new draft guidance to improve the care of adults nearing the end of their lives.

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