It is still thought by many
that palliative care and hospice
mean the same thing:
“somewhere to go to die.”
The term “palliative care”
(in French: Soin Palliatif) was
coined by Canadian urologist
Dr Balfour Mount
in the 1970s
because of the historical association
in the Canadian francophone community
of the term “hospice” with the destitute.
https://web.archive.org/web/20210120130800/https://journals.sagepub.com/doi/pdf/10.1177/1178224216688887
Individuals likely to be approaching the last year
of life should be proactively identified and offered
the opportunity to discuss this with an appropriate
care professional. Those important to the individual
should be included in this discussion, if the
individual wants this.
An holistic assessment of the individual’s needs
should be undertaken by an appropriate care
professional applying a standardised approach.
A person-centred plan of care should be
formulated and agreed with the individual and
those important to them, by appropriate care
professionals. An opportunity for future care
planning should also be provided.
All appropriate relevant professionals, including
those involved in crisis care, should be able to
read, update and share electronic records of care
plans and Advance Care Plans if consent has been
given.
Holistic care should be provided in the most
appropriate setting (respecting the individual’s
choice where possible), at the right time, ensuring
all appropriate medication and equipment are
available, with coordinated care providers
involved.
Informal identified carers will be recognised as
being integral to care planning, delivery and review.
They should be offered a carers assessment and
their needs be agreed and supported, if they wish.
Individuals and their carers should be reviewed as
part of a standardised assessment, on request or
as their needs, preferences or situation changes,
to ensure the care being provided is needs led,
with adjustments made as required. This will be
reflected in the individualised care plan.
Individuals should know at all times who and how
to contact services, especially in a time of crisis.
Care plans should be available and accessible,
and individuals should receive responsive care
linked to their urgent care needs.
Where the possibility is identified that an individual
is likely to die in the coming days, they should
be assessed for possible reversible causes,
before being recognised as dying. If appropriate,
and in accordance with the individual’s wishes,
the assessment should be discussed with the
individual and those important to them.
Individuals in the last days of life should be cared
for in accordance with their wishes and supported
by a holistic plan of care, tailored to that individual
and those important to them.
Individuals who have died, and those important
to them, should be continued to be cared for in a
sensitive, dignified and culturally appropriate way
in accordance to their wishes.
Access to appropriate bereavement support at the
point of need should be available and offered or
directed to as necessary.
Specialist Level Palliative Care services should be
available for face to face contact seven days a week
across all settings, and advice should be available
24 hours a day. Inpatient specialist palliative care
provision should be available to those requiring it,
with admissions seven days a week.
Services should be available, accessible, equitable
and responsive so that individuals can access
appropriate services including:
☛ Adequate provision of coordinated services,
which are able to communicate effectively
☛ A workforce who are knowledgeable,
appropriately trained, competent and have the
right qualities to support individuals
The community should have support structures
in place to actively encourage discussions about
death and dying and encourage communities to
support those dying in their community.
All providers of care and support should promote
the values of innovation, research, audit, evaluation
and patient and family reported outcomes of
care within their organisations. This will underpin
evidence based, high quality and effective
provision and delivery of care.
