There are many ways that can assist you in recognising the end-of-life. Think about some of these ideas.
Last updated 28 March 2017
- Think about all the patients in your care today. Ask the ‘surprise’ question about each patient.
The ‘surprise’ question: Would you be surprised if this patient dies within the next few months/weeks/days?
Is it time to initiate a conversation about end-of-life care?
- It only takes a minute. Listen to Imogen Mtichell explain why using triggers and tools can help hospital staff recognise end-of-life and start discussing the best care for this patieent.
- Timing of discussion highlights some points where beginning a conversation may be useful.
- Recognise the next time a patient uses one of the end-of-life triggers. If the patient wishes, start a conversation about their concerns and preferences. Use active listening and empathy but be honest and do not shy away from using the word ‘dying’ or provide false hope. Make sure their preferences are recorded and shared with other team members.
- Use SPICT (Supportive and Palliative Care Indicators Tool) to identify patients at risk of deteriorating and dying. The SPICT was developed by The University of Edinburgh for the Scottish NHS.
- Check your patient is still happy with their care plan. Let them know they can revisit their care plan. A trigger for this might be:
- the patient raising questions about an aspect of their care,
- a deterioration in their condition,
- new symptoms, or
- when they transition to a terminal phase.