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Acute care resource: End-of-life care in the acute care setting

30% of acute inpatients are in their last year of life, but it can be difficult to deliver high-quality end-of-life care in acute environments, despite the commitment and willingness of staff to do so. This resource is designed to support acute and general physicians in the care and choices they provide to patients in the acute care setting who are approaching or at the end of their life.

End-of-life (EOL) care for patients should be individualised. Patients’ choices are supported when there is excellent holistic care, and sensitive and honest communication with patients, families and between all members of staff and the teams caring for them. In acute settings, active treatment is often the default course of action, such that busy teams may find it difficult to pause and recognise that someone is dying until that person reaches their final hours or days. This resource supports physicians to identify patients in the acute setting who are dying, to start EOL conversations with patients, families and carers, and to recognise that every patient will have different priorities in how their EOL care is managed.

This resource provides:

  • guidance on how to identify people in the last year of life
  • suggestions for starting a conversation about EOL care
  • the role of advanced care planning and specialist palliative care
  • advice on clinical management and anticipatory prescribing for the dying patient
  • recommendations for professional development in EOL care
  • an addendum on care of the dying patient with COVID-19.

This updated guidance refers to and should be used in conjunction with our Talking about dying report.