Topic 6: Terminal care and bereavement support

To provide care at the terminal phase for a person with a life-limiting condition, it is important to understand that experiences are different for everyone and individual goals of care determines the approach.

Overview

Topic 6: Terminal care and bereavement support describes how to recognise when someone is dying and developing a plan of care for this phase based on a revised assessment of their preferences and care needs.  For the purpose of this resource, the terminal phase will be the last 48 hours of life. 

Aims & Objectives

After completing this topic, you should be able to:

  • recognise the terminal phase of a life-limiting condition
  • identify person-centred goals of care in the terminal phase of a life-limiting condition
  • outline cultural, ethical and legal considerations in the terminal phase of a life-limiting condition
  • develop an understanding of providing care after death
  • identify strategies for providing support to bereaved families and carers.

Sessions

6.1 Recognising the terminal phase

  • describe the signs and symptoms commonly experienced in the terminal phase of a life-limiting condition
  • identify validated assessment tools used in the terminal phase.
  • Recognising dying – signs and symptoms
  • Assessment in the terminal phase

6.2 Reviewing goals of care in the terminal phase

  • identify strategies to understand preferences in the terminal phase
  • outline ethical and legal considerations in the terminal phase of a life-limiting condition.
  • Preferences in the terminal phase
  • Documenting preferences – care planning
    • End of life care pathways
  • Ethical issues in the terminal phase
    • Withholding and withdrawing treatment
    • Myths about morphine
    • Decision making conflicts 

6.3 After death care

  • outline the legal and organisational requirements after a person dies
  • demonstrate care of the person after death which reflects respect and is culturally appropriate.
  • Notification
    • legal and organisational requirements
    • Who needs to be notified
    • Patient confidentiality
    • Role of coroner – autopsy
    • Documentation
  • Care of the person
  • Ensuring dignity
    • Culturally appropriate care
    • Preparing the body
  • Case study – Support for Amy’s family at the end-of-life

6.4 Bereavement

  • describe resources available to support individuals and families requiring grief and bereavement support.
  • Supporting families
  • Culturally appropriate information and resources
  • Referral to pastoral care or social work

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