Care of the dying person
The care a patient receives in the last hours to days of life is important: it has a significant impact on their quality of life and death, and on the psychological well-being of their loved ones and the team delivering care. Most deaths are not sudden or unexpected, but recognition that a patient is dying is challenging. Clinicians’ estimates of survival are often inaccurate, with a tendency towards over-optimism, yet clinical teams must be able to agree goals and care plans with patients and their loved ones while acknowledging and communicating the uncertainty inherent to prognostication. Shared individualized decision-making is essential: patients must be offered the opportunity to participate in decisions, but a preference not to be involved should be respected. The aim must be to agree an individual plan of care that incorporates the needs and preferences of the person and those close to them.