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Monday 29 January 2018
The End of Life working group is pleased to launch a number of resources to support improved end of life care including:
For patients who are actively dying, the end of life pathway has been revised and an observation chart for palliative care has been implemented to assess and document patient symptoms. The observation chart can be used alone or in conjunction with the early warning tool. There are also resources to support the care of the bereaved.
There is a perception that healthcare is very much about curing illness, repairing injuries and restoring function and many people, including clinicians struggle with conversations about care when cure or restoration of function is not possible, including care towards the end of life.
We know that care provided in the last 6 to 12 months of life impacts on symptoms, quality of life, and distress and grief for patients and their loved ones. In addition, patients who receive earlier palliative care have improved quality of life and psychological parameters and also live longer, despite receiving less aggressive care at the end of life. Unfortunately, many patients who are at the end of life undergo treatments or processes that are not beneficial because we have not taken the opportunity earlier in their care to discuss what is most important to them.
A systematic review conducted in 2016 of a range of studies found that, on average, a third of patients receive non-beneficial treatments until they die. Non-beneficial treatments include any treatments, procedures or tests administered to patients who are naturally dying which:
Recognising when a patient is approaching the end of life is critical to delivering compassionate and appropriate care. Effective end of life planning involves open communication with patients to help them consider, discuss and document their values and preferences for care. We have a shared responsibility to discuss what matters most to patients and their families when they are facing difficult treatment decisions. It is also important that the plan of care is reviewed as the condition of the patient changes.
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