Medical treatment comes in two broad types: ‘curative’ – fixing things; and ‘palliative care’ – managing things: care and treatment for comfort, control of pain.
Palliative care starts when doctors agree treatment is no longer effective and may do more harm than good. Palliative care is provided by teams working across health and care: the GP, hospital staff, social work staff, district nurse and others. This step-change may mean a review of medicine, stopping some treatment, coming off machines and other changes. These would be discussed with the patient and his or her close family if appropriate.
Palliative care aims to make it more possible for people to die a good death and should help the 2 out of 3 of us who would rather die at home to do just that.
Doctors and nurses are encouraged to discuss how a patient wants to be treated – or not – in the final days and hours and record these wishes. All medical and care staff share access to this care plan for patients and plans are usually kept openly for family to view too.
Understanding the need for end of life care and support before ‘the end phase’ is the number one hot topic for doctors. Achieving this is particularly challenging for people with long term conditions where it’s harder to identify the beginning of the end.
The Social Care Institute for Excellence has published 15 statements guiding professionals on the care they should provide in someone’s last year. They agree with Age UK that respect and dignity in care and communication are critical factors.
See the NHS Gold Standards Framework.
Find more patient information on end of life care in the UK.
Priorities of Care is the guidance to medical and care professionals to steer them on supporting individuals in the dying phase of life. (This replaced the criticised Liverpool Care Pathway.) Find out more about current approaches to palliative care in Scotland.
(The Liverpool Care Pathway was a model of care used across the UK that came under criticism and has been replaced.