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End-of-Life Care:
EOL care refers to care that is provided during the terminal phase and/or last days to weeks of a patient's life. Typically these patients will have a Palliative Performance Scale (PPS) score of 30% or lower.
It is particularly important that a patient's wishes and goals of care (GOC) are addressed and respected during this phase. Therefore, these conversations are best started earlier in a patient's trajectory.
End of life and palliative care focuses on improving the patient's quality of life – helping them manage symptoms and providing emotional, spiritual and practical support for the patient and family.
Everyone is different, so it’s not easy to say exactly what will happen when someone approaches the end of their life. But in the last weeks and days before death, it’s common to experience certain changes. (for additional information)
- eating and drinking less, difficulty swallowing
- weight loss
- feeling weak/sleeping more
- talking less
- inability to regulate temperature - feeling hot/cold
- incontinence
- breathlessness, noisy breathing
- may have symptoms such as - pain, nausea/vomiting, restlessness/agitation
- Delirium
Medications required to manage symptoms, most likely will be changed to subcutaneous route and should be ordered in advanced to be prepared for quick changes.
Not all illness trajectories are the same (i.e. Dementia, COPD, ALS etc.), some have a slower decline. We need understand illness trajectories and look at the complete clinical picture when trying to establish if a patient is approaching EOL.
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