title: Care of dying adults in the last days of life .
abstract: Care of people in their last days of life should be based on compassion, respect and, wherever possible, on research evidence. Previously the Liverpool Care Pathway attempted to facilitate this but it was withdrawn after an independent government report found that its uncritical implementation could lead to poor care. This Concise Guideline overviews NICE Clinical Guideline (NG31), which addresses: recognising dying; communication and shared decision making; maintaining hydration; and pharmacological symptom control, including anticipatory prescribing. Doctors may need to change their attitudes to care of dying people and those important to them. Specific areas where practices will need to reflect the individualised approach to care are highlighted. Limitations of the guideline are discussed. Potential barriers to implementation include need for further training and 24/7 availability of specialist support to front-line clinicians.
authors.affiliation: National Clinical Guideline Centre, London, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hodgkinson
authors.affiliation: National Clinical Guideline Centre, London, UK.
authors.forename: Josh
authors.initials: J
authors.lastname: Ruegger
authors.affiliation: Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK.
authors.forename: Antonia
authors.initials: A
authors.lastname: Field-Smith
authors.affiliation: National Clinical Guideline Centre, London, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Latchem
authors.affiliation: Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: Sam H
authors.initials: SH
authors.lastname: Ahmedzai
mesh_terms: D003657:Decision Making; D004645:Empathy; D006801:Humans; D010166:Palliative Care; D017410:Practice Guidelines as Topic; D057285:Precision Medicine; D013727:Terminal Care
keywords: End-of-life care; anticipatory prescribing; communication; hydration; individualised care; palliative care; primary care; recognition; shared decision making; symptom control; training