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Implementing the NICE Clinical Guideline on Care of the Dying Adult

Chaired by Dr Jane Bywater Trustee The National Council for Palliative Care & Palliative Medicine Consultant, today's Care of the Dying Adult conference focuses on the new national Clinical Guideline for Care of the Dying Adult which was published by NICE on 16th December 2015.

Barbara Pointon MBE Ambassador The Alzheimer’s Society opens the conference with a session on Putting personal experience first, looking at :

  • ensuring engaged, informed individuals and carers
  • improving information about what to expect at the end of life 

In her presentation Barbara stated:

‘When a person is approaching death, rationality goes and an almost primitive instinct comes to survive’ ‘If my husband had a desire to live I had to support him in that’

‘When a person is giving up the fight to live – I feel only the nearest and dearest can see this’

‘Over the years my husband was ill, he had a large web of care – 17 different healthcare professionals ranging from GP to Occupational Therapist, and some gave conflicting advice. What I found was missing was somebody co-ordinating all of his care’

‘The one thing that can make all the difference is to have a named lead healthcare professional to offer the right kind of care. Co-ordinating everything -  I have been talking about this for years’

‘Hearing a familiar family voice is so helpful – also stroking their face or hand – just letting them know you are there and they are not alone’

‘It isn’t the length of life that’s important, it’s the quality of life’

Barbara's full presentation is available here

Dr Joy Ross Palliative Care Consultant The Royal Marsden NHS Foundation Trust continues with a focus on the New NICE Clinical Guideline on Care of the Dying Adult, and covers:

• the NICE Clinical Guideline on Care of the Dying Adult
• implementation in practice
• priorities and challenges 

In her presentation Joy stated:

‘Healthcare professionals need to know how to seek support from more experienced staff’

‘There needs to be opportunity and resource to regularly review the care plan – sharing the information between healthcare professionals remains an ongoing challenge’

‘It is important to recognise dying – assessing for changes in signs and symptoms’

‘Communication and shared decision making – identify the most appropriate person to discuss the prognosis’

‘Put the dying person at the centre of everything’

‘A big issue is maintaining hydration – encouraging oral intake as much as possible – communication around this is so important’

‘Dr’s and nurses need to put aside prior biasis and their own preferences’ ‘All front line staff need re-training in the new guidance’

‘A challenge we have is thinking that the medical care is what the patient needs compared to the quality of life for the patient’ ‘We need to take time to explore the families understanding of what is happening’

Amanda Cheesley Professional Lead Long Term Conditions RCN presented a session on Informing and engaging with individuals and their loved ones to plan for end of life: implementing every moment counts, inlcuding:

• developing understanding about benefits of effective narrative with individuals and their loved ones
• using information gained from National Voices narrative for end of life care
• identifying the most appropriate professional to discuss advance care wishes and communicate about dying maybe can be better still but that is a start.

At today's conference Amanda stated:

‘My passion has always been to make sure the patient makes decisions and plans for end of life care’

‘People will remember people who do the right thing and are kind’

‘We have to treat the person who is dying as if they are our family’

‘The person in front of us has needs and wants which we might not necessarily agree with. It important for us to listen to them and learn what is important to them’

‘When looking at complaints they are usually down to poor communication’

‘We have to stop being so fixated on the protocols and policies, and we need to use our common sense’

‘Its such a privilege to know you have done the best and cared for someone to the very best of your ability’ ‘if you can say I did the best I can do for this person then you can’t do any more’

Amanda's full presentation is available here

Also of interest:

Effective Nurse Prescribing in End of Life Care
Friday 15 April 2016
Hallam Conference Centre, London


19 May 2016


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