Nurses who provide care to patients at the end of their lives should move away from the ‘blanket’ approach of the Liverpool Care Pathway (LCP) and towards a more individualised form of care, according to new NICE guidelines.
The guidelines were created after the LCP was withdrawn after a government review identified failings in areas such as the provision of medication and evidence of medical treatment being given without prior warning. The new guidelines emphasise the need for healthcare professionals dying to put the patient at the centre of decisions about their care, so that they can be supported in their final days in accordance with their wishes.
‘Until now we have never had guidelines in this country on how to look after people at the end of life,’ said professor Sam Ahmedzai, Emeritus Professor of palliative medicine at the University of Sheffield and chair of the guideline development group. ‘This evidence-based guideline provides a good overview of how to give good end of life care in any setting in the NHS.’
A key recommendation in the guidelines is that a terminally ill patient should be assessed at least once every 24 hours. They state that a patient, and their family, should be given accurate information about their condition, an opportunity to discuss their fears and anxieties, and information about how to contact members of their care team.
Additionally the guidelines cover assisted hydration stating that a dying person should be able to drink water if they are capable and want to.
‘The main way this guideline differs to the LCP is that it stresses an individualised approach rather than a "blanket" method of using the LCP in an unthinking way,’ added Professor Ahmedzai. ‘The guideline also stresses that the patient should be reviewed daily, and the person should always be taken as an individual.’