1. The Dying Patient & Management
Liz Penny
Ian Fenwick
Macmillan GP Facilitators
Bradford & Airedale

2. Poor Care of the Dying – Effects on Patient & Family
Patient and family are unaware that death is imminent
Patient loses trust in doctor as their condition continues to deteriorate without acknowledgement
Patient and relatives perceive disagreement in the team and get conflicting messages regarding the patient’s condition
Patient dies with uncontrolled symptoms including pain/agitation leading to a distressing and undignified death

3. Poor Care of the Dying – Effects on Patient and Family
Patient and family feel dissatisfied with the communication which seems not to be appropriate for the patient’s condition
At death CPR is inappropriately initiated
Cultural and spiritual needs are not met
Outcome - complex bereavement issues, formal complaints regarding care, feelings of failure by staff ,

4. How to recognise that someone is in the near-death stages:

5. ANTICIPATORY DRUGS
HALOPERIDOL
MIDAZOLAM
HYOSCINE
DIAMORPHINE

6. EXAMPLE INJ HALOPERIDOL 5mg / ml 5 X 1ML amps as dir
INJ HYOSCINE BUTYLBROMIDE 20mg / ml
5 x 1ml amps as dir
INJ MIDAZOLAM 5mg / ml
5 x 2ml as dir
INJ DIAMORPHINE 5mg
5 ( five ) x 5mg ( five milligram ) as dir
WATER FOR INJECTION
10 X 10mls amps