P-106 Recognising distress and bodily changes in the last hours or days of life

Abstract

Background Between 56%–74% of the Great British public report their preference is to die at home (National Audit Office, 2008). Around half of all deaths occur in hospital although there are few clinical reason for admission, (National Audit Office, 2008; Berry, Brink, Harris et al., 2017) suggesting the need for greater community support to avoid inappropriate hospital admission. Aims Ambitions for Palliative and End of Life Care (National Palliative and End of Life Care Partnership, 2015) set a framework for action; six ambitions to urge change at the end of life for individuals and those important to them to enable a good home death. Method The leaflet guides them through symptoms which their loved one may experience. It offers education and practical information; helping the relative feel useful at a time when they perhaps feel helpless. The subjects cover those ‘normal’ symptoms considered to be the most distressing in the dying process. Results The patient information leaflet will support and educate all those involved in the care of the dying person. The Community Palliative Care Specialist Nurse focus on prevention and relief of symptoms, in a prompt and timely manner to improve the quality of life for the patient and their family (World Health Organization, 2002). Continually assessing the signs and symptoms which may suggest that a person is in the last days of life will allow for compassionate and responsive care provision (NICE, 2015). Conclusion There is scope for more people to die at home by improving training and understanding of end of life care needs. In May 2015, The Parliamentary and Health Service Ombudsman identified palliative care failings in the report ‘Dying without dignity’ suggesting that the ability of health professionals to recognise the dying person and responding to their needs was inconsistent.