When it is thought that a person may die within the next few days or hours of life, the priorities are that:
- This possibility is recognised and communicated clearly, decisions made and actions taken in accordance with the person’s needs and wishes, and these are regularly reviewed and decisions revised accordingly.
- 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 families 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 and psychological, social and spiritual support, is agreed, co-ordinated and delivered with compassion.
In Wales, the Care Decisions Tool for the Last Days of Life has been developed to support care at this time, emphasizing four core principles:
- good symptom control
- good communication (with family and carers, as well as the dying person)
- holistic care (physical, psychological, social and spirirtual)
- individual care
The Care Decisions Tool supersedes the Care Priorities, Integrated Care Priorities, ICP and Care Pathway for the Dying.