Around half a million people die each year in England and the issues considered to be important at this time can differ enormously from one person to another.
Preparation for death, communication with carers and physicians that is sensitive and responsive, and being treated with dignity and respect are often deemed significant. National Institute for Health and Clinical Excellence (NICE) has published its new quality standard (QS) for end of life care for adults. The QS provides specific, succinct statements and measures that describe aspirational but achievable care for adult patients across the NHS in England. This latest quality standard includes 15 statements for the care of adults (18 years and older) with advanced, progressive, or incurable conditions who are approaching the end of their life and are expected to die within the next 12 months. The end of life definition also includes adults with existing conditions who are at risk of dying from a sudden, acute crisis in their condition, or those with life-threatening acute conditions caused by sudden catastrophic events. The standard also covers support for the families and carers of such people. The quality standard statements include:
• People approaching the end of life and their families and carers should be communicated with, and offered information, in an accessible and sensitive way in response to their needs and preferences.
• People approaching the end of life should be offered spiritual and religious support appropriate to their needs.
• People approaching the end of life should have their physical and psychological needs safely and appropriately met at any time of day or night, including access to medicines.
• People closely affected by a death should be communicated with in a sensitive way and offered and ongoing bereavement, emotional and spiritual support appropriate to their needs.
