End of Life Care Policy

Aim

The aim of Cavendish Homecare Professionals is to provide high-quality care with dignity and compassion for those who are dying, abiding by the appropriate customs of religious culture and practice and supporting the dying person’s family throughout.

Policy

Clients, and those acting on their behalf, will be involved in the assessment and planning for their end of life care and will be encouraged, where appropriate, to make choices and decisions about their preferred options, particularly those relating to pain management.
Clients, and their families or those close to them, will be provided with sufficient information relating to death and dying.
During the needs assessment process, the client and their family’s specific wishes and instructions regarding death and dying will be discussed, if the client is happy to do so. Their wishes will be clearly documented in the client’s plan of care. This ‘advance care planning’ is designed to ensure that clients are comfortable that everything has been arranged and that their wishes will be respected after their death.
Where a client lacks the capacity to make informed decisions relating to end of life choices, Cavendish Homecare will apply the best interests principles of the Mental Capacity Act 2005 as required.
The client’s right to choose to die in a place of their choice, where medically possible, will be respected and appropriate support arranged and given. All clients who wish to die at home will have their wishes respected wherever possible and appropriate.
At the end of life the client will be made as comfortable as possible and his or her comfort will be checked regularly. A normal routine will be continued with respect to hair washing, shaving, chiropody and so on, unless the client expressly wishes this not to be so.
As far as possible the dying client will be kept free from pain and the client ‘s GP will be consulted to advise on what kind of painkillers the client wants or needs. Cavendish Homecare will welcome the involvement of specialist community nurses skilled in care of the dying to support the client and ensure that they are made as comfortable as possible. Arrangements will be made to minimise any unnecessary disruption to the care, treatment, support and accommodation of the person, their family and those close to them.
Care will be provided according to a recognised care pathway and this will include systems in place to ensure further assessments by specialist palliative care services and other specialists, where needed.
All personal care tasks will be carried out in a dignified and respectful manner. Staff will pay particular attention to good mouth care and continence. The client will be given food and drink as they wish.
Staff will encourage relatives and friends to visit as often as possible and at any time. Relatives will be offered emotional comfort and support. Staff will make sure that relatives are kept informed and up to date with the client ‘s treatment and condition and facilitate discussion with the client ‘s GP if necessary. All clients can ask to have a visit from someone important to their faith and this will be facilitated by the home. Staff should do all that they can to comply with and to support the religious belief and faith needs of the client at end of life.
Every effort will be made to ensure that the family of a dying patient, or others who are important to them, are able to be with them at the time of death if they wish. Cavendish Homecare will contact immediate family where death appears imminent. If they are not present at death, the next of kin will be notified immediately.
Where a client does not have a relative with them at death then a member of staff will be with them.
Last offices will be administered in a dignified, respectful and private manner by suitably experienced members of staff as appropriate to the beliefs and customs of the client.
Where a resident’s death is ‘expected’ the legal verification of that client’s death will be performed by a suitably qualified registered nurse.
Information, documentation, contact telephone numbers and advice on what to do following a death will be given to the family of the deceased by staff.

Management duties

Managers home have a duty to:

Ensure that this policy is operated at all times and to keep all aspects of it monitored and under review.
Investigate any complaints relating to end of life care in the client’s home, and review relevant incident reports, looking out for any trends or patterns that may indicate that improvement action needs to be taken.
Communicate this policy to employees, agency staff, volunteers and relevant others.
Provide training and guidance as appropriate, including training on induction and management courses covering respect for clients and end of life care issues, and ensure the attendance of staff.

Staff duties

Staff have a duty to:

Respect the clients’ privacy and dignity at all times, especially when performing personal care tasks, and treat clients with compassion, sensitivity, respect and thoughtfulness.
Knock before entering a clients’ room and always address clients by the title or name that they prefer.
Allow clients to do things for themselves whenever appropriate and maintain their independence wherever possible.
Keep information about clients confidential and never discuss private or personal issues with a client in public or gossip about clients.
Attend training in end-of-life care provision as required.

Date: January 2024

Version 6 (Review)

Source: ECM