End-of-life guide for acute care

A NEW acute care resource for managing patients at the end of life has been published by the Royal College of Physicians London in collaboration with the Society for Acute Medicine.

The guide is intended to support hospital doctors in improving the care and choices provided to people at the end of their life. It provides guidance on how to identify people in the last year of their life and suggestions for starting a conversation about end-of-life (EOL) care.

The resource also sets out the role of advance care planning and specialist palliative care, and offers advice on clinical management and anticipatory prescribing for the dying patient. It includes an addendum on care of the dying patient with Covid-19.

The emphasis is to ensure that patient choices are "heard and supported in a holistic and sensitive way".

Dr Sarah Cox, lead clinician for the end-of-life care resource, said: "We know that around 30 per cent of hospital inpatients are in their last years of life, and yet in a busy hospital setting, it can be hard to identify when a patient is at the point of needing end-of-life care.

"This resource was produced with that in mind, aiming to equip doctors with the tools needed to identify patients in those last days or weeks of life, and to have open and honest conversations with them about the care they want to receive."

The majority of patients who express a preference would prefer to die at home, but currently only 45 per cent of people at the end of their life die in their usual place of residence.

Link: End-of-life care in the acute care setting