End of Life Care Policy
Code: C8.2
Date: 17/06/2014
Last Updated: 06/09/2015, 12/04/2025
Purpose:
To ensure that clients approaching the end of their lives have appropriate support.
To provide adequately for the needs of families after the death of a client.
Responsible Staff:
Implementation: Clinical Director
Action: All Staff
Audit: None
Training Resources:
Linked Policies:
Enabling Resources:
Policy:
All clients who are assessed as needing support at the end of their lives shall be entered onto the Vulnerable Client List.
The purpose of this is to aid speedy identification of these clients in the event of an emergency and to aid communication with the deputising service during periods of practice closure.
It is expected that all dying clients (or their families) shall be given the mobile number of one of the medical staff so that they can obtain advice and support easily. Usually this will be their usual doctor's phone number although on occasion it may be appropriate to provide another number.
Emergency contact numbers for all clinical staff shall be registered with our telephone triage service and the deputising service.
Where a specific need has been identified, it should be recorded in the clinical notes AND and alert should be created to direct staff unfamiliar with the case to the care plan. An annotation to this effect should also be made on the Vulnerable Client List.
It may be appropriate to consider creating a care plan in CCMS or creating an Advanced Care Plan. Both should be in consultation with the client.
After Death
A condolence card should be sent unless it is clearly inappropriate.
Consideration should be given to calling relatives who are also clients soon after the death to offer support. The timing and nature of such approaches is a matter for clinical judgement though to prevent confusion, please:
Read the clinical notes of the client and the deceased to ensure there is no confusion.
Speak with other staff who were involved with care.
Write clear notes of what was said and to whom.
It may be appropriate to set an alert on the notes of the recently bereaved (if a care plan has been considered, please include its date of entry in the records)
Staff are welcome to offer relatives an extended appointment at no additional charge or, if necessary a free appointment using funding in the following order: Care Plus, SIA, Discretionary.
When it is likely that the client will have less than three months left to live, there is funding available to cover palliative care. There is no funding for periods over three months - each client has only one three month allocation available so it is important that this is not initiated until death is likely in the next three months.
Implementation Notes
The Vulnerable Client List is maintained by using the screening entity 'VULN' and adding appropriate details to this.
The list is printed every three months so it is important to inform the Quality Administrator when a client has been added.
Change Log:
06/09/2015
Added implementation notes section
17/06/2014
Removed deprecated practice manager role.
Minor wording alterations
Addition of recommendation to create Advanced Care Plans.