Care at the End of Life

Critical care teams frequently have to deal with uncertainty of prognosis and outcome, simultaneously react to changing physiology with resuscitative measures, consider palliative interventions and communicate (with empathy) rapidly changing situations to patients and families during very distressing times.  Shared decision-making is regarded as best practice but lack of capacity often precludes this.  If more information about patients’ wishes and beliefs were available ICU teams would be better positioned to make Best Interests decisions, enabling individualised care, thereby minimising confusion and conflict due to clear communications about advance care planning.

                      

This document (full and abridged versions) plus the accompanying lay summary provides recommendations for effective decision-making and resources for clinical teams and the general public.  It hopes to encourage open, clear, honest discussions with patients and families enabling improved advance care.  Such arrangements will enhance care planning and empower patients, carers and clinical teams to better engage in shared decision-making processes that respect both the philosophical and physiological aspects of individuals’ lives. 

 

Care at the End of Life: A guide to best practice, discussion and decision-making in and around critical care

 

Care at the End of Life: A guide to best practice, discussion and decision-making in and around critical care - Executive Summary

 

Care at the End of Life: A guide to best practice, discussion and decision-making in and around critical care - Summary for Patients, Relatives and the Public

 

Useful resources and links:

 

Compassion in Dying have created some useful forms for patients: a Advance Decision to Refuse Treatment form and an Advance Statement form.