NICE produces new draft guidelines on caring for the dying

The draft guideline is out for consultation with stakeholders between 29 July 2015 and 09 September 2015.

A few of the main points are detailed below:

Recognising when a person is in the last days of their life

If it is thought that a person may be dying, information should be gathered on their:

  • clinical signs and symptoms, and medical history
  • the person’s goals and wishes, as well as their psychological and spiritual needs
  • the views of those important to the person with respect to future care

The assessment of their clinical state should be made on a team basis and not just by one individual. The assessment should be reviewed at least every 24 hours.

Communication

Establish their communication needs, their current level of understanding and how much information they want to know about their prognosis. If patients or their families do want information, staff should discuss any concerns they have, while avoiding giving false hope.

Shared decision making

Find out how much the person wants to be involved in terms of shared decision making when it comes their care plan. As part of this process, find out whether the person has an advanced care plan or decision in place, as well as their goals and wishes.

Hydration

A dying person should always be supported if they wish to drink and are able to, though it is important to check for potential risks, such as swallowing problems.

Encourage friends and family to help with giving drinks and mouth care. Provide any necessary aids, such as sponges.

Discuss the risks and benefits of clinically assisted hydration, such as intravenous feeding, and their wishes about its use. It is also important to make clear that clinically assisted hydration is unlikely to prolong life.

Pharmacological interventions

Discuss what level of symptom control they would want in the last days of their life, as well as the possible benefits and harms of any medicines offered.

The plan for pharmacological interventions should be regularly reviewed.

Read the NHS choices article via NICE produces new draft guidelines on caring for the dying – Health News – NHS Choices.

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