Palliative and end of life care

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Palliative care, end of life care and bereavement support are essential components of holistic person-centred care for people nearing the end of their life.  At this time many staff will be working outside their specific areas of training and expertise and are more likely to be working with people either with pre-existing palliative care needs or with end of life care needs because of Coronavirus (COVID-19).The resources in this section are intended to enable staff working across all health and social care settings to provide the best possible support to people at the end of life. 

Always follow the most up-to-date guidance on Palliative Care.

You will also find on the page temporary guidelines now available for symptom management: 

Please also note the Good Practice Recommendations for use of antibiotics towards the end of life from the Scottish Antimicrobial Prescribing Group (SAPG).

The following topics appear on this page: 

It is also essential that you follow the Health Protection Scotland Guidance on COVID-19 relevant to your area of practice.

What is palliative and end of life care?

The following document provides some background information on palliative and end of life care.

Informed about palliative and end of life care

This is an introductory learning resource for anyone who comes into contact with people who need palliative and end of life care, their families, and carers.

It is made of a mixture of reading and learning activities that can be applied to any work setting, and is divided into five main sections :

  • fundamentals in palliative care;
  • communication and conversations;
  • loss, grief and bereavement;
  • care planning and delivery; and
  • care in the last days of life.

This learning resource is based on the knowledge statements at the 'Informed' level of the 'Palliative and end of life care : enriching and improving experience' learning framework developed by NHS Education for Scotland and Scottish Social Services Council.

End of life care for older people with complex health care needs

These PowerPoint presentations and associated notes aim to support staff to provide high quality end of life care to older people with complex healthcare needs, frailty and dementia across all care settings.They cover three key areas:

It is recommended that these three topics should be worked through in the above order. 

Care homes and Coronavirus

Many of the older people and people with complex health care needs who are potentially at greatest risk from COVID-19 live in care homes.

Care homes across Scotland are implementing a range of measures to protect the health, safety and well-being of residents and their families and reduce the spread of this disease.

Dr Paul Baughan, Scottish Quality and Safety Fellows, with Hazel White from Open Change, have created a 5 minute video to guide staff in care homes and health care professionals working with them to provide safe, high-quality care and reduce the spread of infection

Supporting communication

Communication is a fundamental component of palliative and end of life care and needs to be empathetic, clear and respectful, with any information tailored to those involved. It includes communication with the dying person, their family and the wider team providing care and support for the person. Good communication enables staff to understand the person’s priorities and wishes and those of their family to support them to make informed decisions about their care. The development of an anticipatory care plan can support the person and their family and carers to plan ahead and enable them to be more in control of the care and support they receive at the end of their life.

It is important to be able to initiate, facilitate and respond to sensitive situations and this may include a number of sensitive conversations with the person and their family approaching the end of their life and after the person has died. In the page on Death and Bereavement you will find a suite of short animations and films to support you to engage in conversations about death and dying. 

The current circumstances around COVID-19 mean that for many staff they may find these conversations about death and dying difficult. Dr Lara Mitchell, Scottish Quality and Safety Fellows, with Hazel White from Open Change, have created videos to support staff in talking to people about dying during COVID-19 pandemic that you may find helpful:

Anticipatory Care Planning (ACP) for COVID-19 

Healthcare Improvement Scotland is currently working with the Scottish Government to develop COVID-19 specific ACP templates and guidance. They have developed some resources that you may find helpful in supporting people with planning and decision making in about their end of life care in the context of COVID-19. 

Decisions Relating to Cardiopulmonary Resuscitation 

Plans should include discussions with the person and their family about whether cardiopulmonary resuscitation should be used at the time of death. You will find further details and resources relating to NHS Scotland's ‘do not attempt cardiopulmonary resuscitation' policies here.

Note: You will need to login with your Turas account to view the video below:

  • Difficult Conversations and Principles of Treatment

This account is the same as your Turas Appraisal account. If you do not have an account then please register for a free Turas account.

Support with death, dying and bereavement during COVID-19 

SSSC have produced an online learning resource, Support with death, dying and bereavement during COVID-19, that you may find helpful. 

You can access this here.

Caring for people who are dying

Caring for people who are dying amidst COVID-19 visiting restrictions

This PDF resource has been designed to support health and social care staff manage situations where a person’s family or close friends are unable to see them before they die. It should help frontline staff feel more prepared and confident to do the best that they can during circumstances which can be challenging and upsetting for everyone involved. The resource presents some general principles, tips for keeping in touch with families and information on the use of phone and video calls. It also highlights the importance of staff looking after themselves and seeking help and support for their wellbeing if they need it.

Spiritual care resource

Supporting the spiritual care needs of those who are nearing the end of life

This PDF resource has been designed to help health and social care staff meet the spiritual care needs of people who are approaching the end of life during the COVID-19 pandemic. It outlines key points and principles including examples of ways to start these conversations and information on rituals and practices around the time of death. It also signposts to where more specific information e.g. on particular belief communities can be found, as required.

Confirmation of Death - Learning resources to support practitioners 

You will find information on this topic on the Death and bereavement site.

Considering the needs of staff in relation to death and dying

The following guidance advises how to cope with the needs of staff dealing with death and dying during the COVID-19 pandemic.

Workforce support and wellbeing during the COVID-19 outbreak 

This webpage gives you advice and guidance to help you look after your own wellbeing, and the wellbeing of others.