End of Life Caring: A Practical Checklist
End of Life Caring: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
Supporting someone in the last months, weeks or days of life. Most people want to die at home and most do not, and the difference is usually planning and support rather than wishes.
Key takeaways
- Palliative care: appropriate alongside treatment, not only at the very end
- Advance care planning: records wishes while the person can express them
- Most useful single change: Ask for palliative care referral early; it is not giving up.
- Commonest mistake: Waiting for a crisis to discuss preferences.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Ask for palliative care referral early; it is not giving up
- Discuss and record wishes while the person can express them
- Ask about hospice at home and district nursing support
Do not
- Waiting for a crisis to discuss preferences
- Assuming palliative care means the last few days
The numbers behind the list
Here are the figures the checklist is drawn from.
| Measure | Figure |
|---|---|
| Palliative care | appropriate alongside treatment, not only at the very end |
| Advance care planning | records wishes while the person can express them |
| Just in case medicines | often left in the home for symptom control |
| Hospice care | free, and includes support for the family |
If you change one thing
Ask for palliative care referral early; it is not giving up. Start there. The rest of the list keeps.
Where to go next
- The Evidence on End of Life Caring, Without the Hype
- Understanding End of Life Caring: A Plain-English Explainer
- End of Life Caring — the reference entry
- The Evidence on Carers and Work, Without the Hype
- When Caring Ends: What the Evidence Actually Says
When to speak to a doctor
Contact the palliative care or district nursing team for uncontrolled pain, breathlessness, agitation or distress — these are treatable and should not be endured. Know in advance who to call out of hours, and keep the number where you can find it.
Where this comes from
- NICE — End of life care for adults
- Marie Curie — caring at the end of life
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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