Editorial

Add your voice to end of life care consultation

The long-running saga over what – if anything – should replace the Liverpool Care Pathway for those close to death in England appears to be nearing a conclusion. The National Institute for Health and Care Excellence issued a draft guideline last week that seeks to resolve the concerns raised by patients’ families that led to the LCP being scrapped in 2014.

The long-running saga over what – if anything – should replace the Liverpool Care Pathway for those close to death in England appears to be nearing a conclusion. The National Institute for Health and Care Excellence issued a draft guideline last week that seeks to resolve the concerns raised by patients’ families that led to the LCP being scrapped in 2014.

A 12-member group that includes a palliative care nurse, community matron and district nurse is developing the guideline. The draft is open for consultation until September 9, with the final version expected to be published in December.

Draft guideline offers detailed advice on what loved ones should be told

The LCP was considered the gold standard for end of life care. The problem was not so much its content, but its implementation, with patients’ families complaining vociferously about a lack of communication. So it is no surprise that the draft NICE guideline on care of the dying adult offers detailed advice on what healthcare professionals should tell the loved ones of someone who is close to death.

As it stands, the guidance promotes shared decision making – with a role for the dying person, healthcare professionals and family members – and recommends individualised care plans are created that are communicated to the multidisciplinary team.

There is guidance on fluid intake, which says people in their final days should receive assisted hydration and that fluids should be reduced or stopped if there is any sign of harm or if there is no benefit. And there is an emphasis on the importance of prescribing effectively, with nurses and other professionals being asked to stop administering medicines that are not providing symptomatic benefit.

The six-week consultation period offers all nurses the opportunity to reflect on the needs of dying people, and what can be done to ensure that everyone experiences the best possible death.

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