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Nurses urged to address dying patients' spiritual needs

Nurses and other health professionals caring for dying people should do more to ask about spiritual beliefs – NICE
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The National Institute for Health and Care Excellence (NICE) is urging healthcare professionals to do more to accommodate the cultural or religious preferences of adults in the final days of life.

New guidance sets out care standards for people in the final two or three days of life in acute and community settings.

The NICE guidance:

  • Advises on signs and symptoms that show a patient is in the final days of life.
  • Recommends use of individualised care plans, and that dying people should be asked where they want to die and whether they have any cultural, religious or social preferences.
  • Emphasises the need to anticipate transition from oral to injected medications
  • Recommends daily hydration reviews.

A 2016 Royal College of Physicians audit of end of life

The National Institute for Health and Care Excellence (NICE) is urging healthcare professionals to do more to accommodate the cultural or religious preferences of adults in the final days of life.


Dying patients' spiritual and cultural preferences often overlooked in hospitals  Photo: Alamy

New guidance sets out care standards for people in the final two or three days of life in acute and community settings.

The NICE guidance:

  • Advises on signs and symptoms that show a patient is in the final days of life.
  • Recommends use of individualised care plans, and that dying people should be asked where they want to die and whether they have any cultural, religious or social preferences.
  • Emphasises the need to anticipate transition from oral to injected medications
  • Recommends daily hydration reviews.

A 2016 Royal College of Physicians audit of end of life care found spiritual wishes were only documented in English hospitals for one in seven dying people who were still able to communicate.

Care beyond pain control

Emeritus professor of palliative medicine and NICE quality standard committee member Sam Ahmedzai said: ‘Control of pain and other distressing symptoms is very important for dying people, but good end of life care goes far beyond that. It includes asking about the dying person's spiritual, cultural, religious and social preferences.

‘How we are cared for can make a big difference to our final days, and lives on in the memories of family and friends.’

NICE deputy chief executive Gillian Leng added: ‘Our guidance will support doctors, nurses and other healthcare professionals so that they can work together to ensure people die with dignity, whenever possible in the place of their choosing and with their symptoms effectively controlled.’

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