Care in the last days of life.

16 Jan 2018

In December 2015, the National Institute for Health and Care Excellence (NICE) introduced new evidence-based guidance on the ‘Care of dying adults in the last days of life’. Arguably, since discontinuation of the Liverpool Care Pathway (LCP), there has been a need for concise, evidence-based guidance on clinical interventions in the last days of life. The LCP was withdrawn owing to concerns that it had led to cases of food and fluids being withheld and situations where medications could have been overprescribed, resulting in unnecessary suffering or over-sedation of the dying person (NICE, 2015). In their review of the LCP, Neuberger at al (2013) identified that it was the lack of staff training, supervision, and poor or indiscriminate implementation that undermined the principles of the LCP rather than the tool offering a poor clinical framework. It was recommended that the tool be replaced by an individualised end-of-life care plan encompassing five key priorities for care (Leadership Alliance for the Care of Dying People, 2014).