When a person is likely to die in the next few days/hours there are five priorities of care that should be applied.
- The change in the patient’s medical condition is recognised and communicated clearly, decisions made, and action taken in accordance with the person’s needs and wishes. These are regularly reviewed and recorded in the patient’s records.
- Sensitive communication takes place between staff and the dying person, and those identified as important to them.
- The dying person, and those identified as important to them, are involved in decisions about treatment and care to the extent that the dying person wants.
- The needs of family and others identified as important to the dying person are actively explored, respected, and met as far as possible.
- An individual plan of care which includes food and drink, symptom control, psychological social and spiritual support is agreed coordinated and delivered with compassion.
Additionally, the delivery of care must be based on and tailored to the needs, wishes and preferences of the dying person and, as appropriate, their family and those identified as important to the person.
Things that may help
Caring for an individual in their last days and hours can be distressing and emotional and for some support staff may have personal circumstances that mean they are not able to provide this care at this time, and that’s okay. It’s important that all staff follow the care plan. Their body is likely to need less food but if a person wants food and can take would not be denied.
The steps outlined below may help those in supporting the individual.
- Keep a contact sheet containing all the telephone numbers of people you may need to contact. (Please use the contact sheet included in this section).
- Obtain an explanatory letter from the GP; this may help if out of hours services need to be contacted.
- Be fully aware of any Advance Care Plans in situ, e.g., ReSPECT and any Do Not Attempt CPR decisions.
- Keep in regular contact with those that have supported the person throughout and don’t forget to express your own concerns or fears and get the support you need to continue your caring role.
- Reminisce good times that involve the individual, listen to their favourite music, or watch their favourite TV programme.
- Spend quality time with the individual.
- Making a memory box that holds recordings, handprints, photographs, or anything special belonging to the person.
Last Day and Hours for Others
Everyone responds differently during the last days and hours of the life of an individual we care for, there is no right or wrong answer to reactions of coping in this situation.
Some people may:
- Cry and display emotions.
- Want to talk.
- Prefer their own space.
- Feel helpless and unable to function
- Need to act or do something.
Remember, try not to panic, it will be a distressing situation for all, don’t feel as though you can’t be upset but don’t worry if the tears don’t come and adrenalin takes over.