The National Institute for Health and Care Excellence (NICE) has established new guidelines for patients who are in the last days of their life, expecting doctors to provide them a respectful and compassionate treatment.
NICE new guidelines are designed to replace the Liverpool Care Pathway (LCP) a protocol that was introduced in 1990, in order to ensure that people have a dignified and comfortable death. However, it was eliminated last year after the government found significant deficiencies in the way it was being implemented.
The LCP protocol had become very controversial over the years since families criticized the inexpert hospital staff that wasn’t able to recognize and manage when their loved ones were on their last stages of life. There were many cases, for instance, in which fluids and medicines were removed from the patients, or in which those patients were over-sedated.
The new guidelines established by NICE are wide ranging, and although they cover many of the same fundamental principles as LCP – recognizing that most of the patients were given good attention – they consider that it should have a greater emphasis on individual plans for each patient, in which they should focus on the wishes of the patient and family.
NICE states that doctors should not make hasty decisions about patient diagnosis, emphasizing the importance in reviews and evaluations of symptoms when they think a person is in the final stage of life. Similarly, they also encourage a more adapted approach to medication for symptom control and anticipatory care.
Between what is written in the document, it also notes the importance of the hydration of the patients, noting that under the previous protocol (LCP) patients were left so thirsty that they tried to suck water from the sponge that moistures the mouth.
So they now established that those who are able to drink, they should be encouraged to do so if it is safe, where family and friends may be able to help; and in the case that a patient can’t swallow liquids, other methods – as under the skin – should be considered.
However, despite the given recommendations, the experts said that there is a lack of evidence on whether to give or withhold liquids in patients lengthens or shortens their life in such circumstances.
Lord Howard, chairman of Hospice UK, welcomed the new guidelines, but he stated that there would be real problems to implement them. According to BBC News.
“There can never be ‘a tick-list approach’ towards caring for the dying and this guidance must be underpinned by greater investment in training and education for all staff involved in end-of-life care,” Howard said. “This is crucial if we are to avoid the failings of how the Liverpool Care Pathway was implemented,” he added.
Source: BBC News