What are the key principles of end of life care that I should communicate to patients and their families?

Key principles of end-of-life care to communicate to patients and their families include:

• Involvement in decision-making: Patients and their families have the right to be involved in discussions and make informed decisions about care, with support from the multidisciplinary team as needed. Their preferences about how much information they want and who should be involved should be respected and regularly reviewed.
• Clear, compassionate communication: Provide accurate, honest information about prognosis and what to expect, while avoiding false optimism. Allow opportunities to discuss fears, ask questions, and revisit conversations as needed. Include those important to the patient if the patient wishes.
• Continuity and coordination of care: Aim to maintain continuity by minimizing changes in healthcare professionals and ensuring access to a lead healthcare professional who can make informed decisions 24/7 and coordinate care effectively.
• Holistic support: Address physical, psychological, social, and spiritual needs of the patient and their family, including siblings and other important people, recognizing their need for support during this time.
• Advance care planning: Encourage discussions about future care preferences, values, and goals, including any advance decisions or legal arrangements, to guide care in the last days of life.
• Symptom management: Prioritize prompt and effective management of symptoms such as pain, breathlessness, nausea, and vomiting, using both pharmacological and non-pharmacological approaches tailored to the patient’s preferences and clinical situation.
• Time and opportunity for difficult decisions: Provide sufficient time and multiple opportunities for patients and families to discuss and understand difficult decisions related to end-of-life care.

These principles ensure care is personalised, respectful, and supportive, helping patients and families to feel involved, informed, and cared for throughout the end-of-life journey.

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