title: Promoting health and wellbeing  at the end of life: the contribution  of care pathways.
abstract: Enhancing end-of-life care (EoLC) is a core component of international governments' health policies. Across the globe, nurses make significant contributions to EoLC and, at this delicate time, have the power to positively influence the health and wellbeing of those facing death. Indeed, health promotion is a core component of the nurse's role. Originating in the UK, EoLC pathways have been adopted around the world. Their broad aim is to optimise the quality of the dying process, enabling people to 'die well' across care settings. This paper examines EoLC pathways in terms of promoting health and wellbeing in this discrete stage of the dying trajectory. Concepts of health and health promotion are described briefly and the idea of health-promoting palliative care and its association with a good death examined. The ensuing discussion relates to two EoLC documents. While acknowledging that much has been achieved it is argued that, despite the potential for promoting health and wellbeing, a professionally led, biomedical approach predominates, and in terms of promoting health and wellbeing at the end of life there is a pressing need for proactive advance care planning at an earlier point in the illness trajectory.
authors.affiliation: Sinngleton Hospital, Abertawe Bro-Morgannwg University Hospital Board, Swansea, Wales, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Allen
authors.forename: Tessa
authors.initials: T
authors.lastname: Watts
mesh_terms: D019091:Critical Pathways; D004059:Diffusion of Innovation; D014943:Global Health; D006284:Health Plan Implementation; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D013727:Terminal Care / Q000379:methods*; D006113:United Kingdom