What Are The 5 Priorities of Care for End-of-Life Patients?

Caring for someone at the end of their life is one of the most profound and sensitive responsibilities one can undertake. The Leadership Alliance for the Care of Dying People (LACDP), a coalition of 21 national organisations including the CQC and NHS England, has outlined five priorities of care to guide healthcare professionals and caregivers in supporting individuals during their final moments. 

LACDP published One Chance to Get it Right (LACDP, 2014a) in July 2014, in which the 5 priorities of care replaced the Liverpool Care Pathway, which was heavily criticised for encouraging a checklist approach to end-of-life care. These five priorities ensure that the needs and wishes of the dying person and their loved ones are met with dignity, compassion, and respect. This article will explore these five priorities and explain how Tiggo Care's staff incorporate these principles to provide outstanding end-of-life care.

Priority 1: Recognising that someone is dying

The first priority is to recognise and communicate clearly when a person may die within the next few days or hours. This involves making informed decisions and taking appropriate actions based on the individual's needs and wishes, which are regularly reviewed and revised.

Recognising ‘dying’

The first step is to recognise when someone is dying. This should be assessed by an experienced doctor, who can decide whether the changes in the patient’s condition are reversible or not and whether there is a chance the individual will die soon. Our carers at Tiggo Care can identify slight changes in a person's condition and escalate those changes to health service professionals so that timely assessments can be carried out.

There is no more difficult step for a family than recognising that their loved one may be dying. Still, this prognosis can make a world of difference to the quality of life that remains. This step looks at what practitioners are doing to assess a patient’s condition, identify their wishes, discuss their fears, and most importantly, practical goals for care delivery. Once decisions are made, they need to be regularly reviewed to ensure they are still relevant and appropriate to the patient.

Talking about death

Once it is acknowledged that a person is dying, this must be communicated with clarity and sensitivity. Euphemisms and euphemistic language are to be avoided; the dying person and their loved ones need to be presented with clear information to make decisions about their care and treatment. At Tiggo Care we understand the importance of these difficult conversations and we will always use clear and simple language to talk to patients and their family with sensitivity. 

Tiggo Care professionals are taught to talk with families as honestly and clearly as possible. Euphemisms and oblique language can make it harder for families to prepare themselves emotionally and can result in poor decision-making. When we talk about dying, we talk about dying – directly but compassionately. Likewise, we take measures to ensure that families understand what’s going on so that they know what to expect and what decisions they might need to make in the immediate future.

Priority 2: Sensitive communication

The second objective highlights the importance of communicating respectfully with the dying person and those identified as most important to them, including listening attentively, addressing concerns and providing them with information as needed.

At Tiggo Care, we believe effective communication is the cornerstone of compassionate care. Our carers take the time to listen to the needs and concerns of the dying person and their loved ones. By fostering an open and honest dialogue, we ensure that everyone involved feels heard and supported.

There are often a lot of questions and concerns for families whose loved ones are receiving end-of-life care. Our care team is trained to provide honest and compassionate answers to help family members as much as they possibly can. This means not only answering direct questions but also helping them to understand their loved one’s condition and care needs.

Priority 3: Involving the dying person in decisions

The third priority is to engage the dying person and those important to them, to the extent that the dying person wishes, in decisions about their care and treatment. This approach values the dying person’s autonomy and enables them to make decisions about their life wherever possible.

Involvement of Families in Decision-Making

Families play a significant role in end-of-life care. At Tiggo Care, we encourage families to be a part of the decision-making processes. Our care staff work with families to understand a dying person’s wishes and we incorporate those wishes into their care plan. The dying person always remains central to all decisions made about their care.

Tiggo Care takes a shared approach to decision-making where possible so that the dying person and their family have the opportunity to express their choices. This facilitates the creation of a care plan that respects the needs of the dying person and ensures a high quality of care.

Professional Responsibility for Decisions About Care and Treatment

This means that – while family involvement is hugely important – for the most part decisions about care and treatment remain with medical or health professionals. Tiggo Care ensures that our carers coordinate with medical teams and follow the best interests and medical needs of their clients. Within these parameters, there is a need to balance the wishes of the dying person and their family with what medical professionals consider the best course of action.

Communicating Professional Responsibility for Care and Treatment

It’s important medical and healthcare professionals communicate their roles and responsibilities to their patients and their family members, particularly so that those who are cared for and their family members know who to approach and when. 

Capacity and Advance Decisions

Advanced decisions are not always easy to make and can only be made by a person with mental capacity. Once a person has clearly expressed advanced decisions about their care, their care team should always respect them, even if their capacity fluctuates. At Tiggo Care, we ensure your advanced directives are acted upon. Advanced care planning is an essential part of end-of‑life care and it ensures advanced decisions are respected, even if the person loses their capacity or ability to communicate their wishes at a later date.

Priority 4: Meeting the needs of families and loved ones

The fourth priority is to actively explore, respect, and meet the needs of families and others identified as important to the dying person. Providing support to loved ones is a crucial aspect of end-of-life care. Tiggo Care recognises the emotional toll that caring for a dying loved one can take on families and friends.

Our carers offer not only practical assistance but also emotional support to family members, helping them navigate this challenging time with empathy and understanding. This involves listening to their concerns, offering reassurance, and providing information about what to expect as their loved one's condition progresses.

Meeting the needs of the family is as important as caring for the dying person. Families need emotional, psychological, and sometimes practical support during this challenging time. At Tiggo Care, our carers are trained to provide this support, ensuring that families feel cared for and understood. This involves regular check-ins, providing updates on the patient's condition, and offering resources to help families cope with the emotional challenges they face.

In addition to emotional support, families often need practical assistance with day-to-day tasks and care responsibilities. Our carers at Tiggo Care help with household chores, meal preparation, and other tasks to lighten the load for families, allowing them to spend quality time with their loved ones. This practical support can make a significant difference in reducing stress and improving the overall experience for families.

At Tiggo Care, we take the time to understand each family's specific situation and tailor our support to meet their needs. This might include providing information about local resources, arranging for specialist palliative care, or helping families navigate the healthcare system. By addressing these specific needs, we ensure that families feel supported and empowered throughout the end-of-life care process.

Priority 5: Individual care plan

The fifth priority involves creating and implementing an individualised care plan that addresses the dying person's needs comprehensively, including food and drink, symptom management, and psychological, social, and spiritual support.

Planning Care

An individualised care plan is tailored to the specific needs and preferences of the dying person. At Tiggo Care, we work closely with the patient and their family to develop a comprehensive plan that ensures comfort and dignity in their final days. This plan includes detailed information about the patient's medical needs, preferences for care, and any specific requests they might have for before and after their death.

Care planning takes a holistic approach that addresses all aspects of the dying person's well-being. At Tiggo Care, we work with the patient and their families to create a care plan that encompasses their physical, emotional, and spiritual needs. This plan is regularly reviewed and adjusted as necessary to ensure it remains aligned with the patient's evolving condition and wishes.

We offer a range of services designed to support patients and their families during their end-of-life journey. For example, our live-in care service provides continuous, around-the-clock support, ensuring your loved one is never alone. A dedicated carer lives in the home, offering assistance with daily activities, personal care, and emotional support.

Food and Drink

The nutritional and hydrational needs of the dying person need to be met so that they can be kept as comfortable as possible. Our carers encourage patients to eat and drink when they can, and as long as it is safe to do so, we care for their oral health too.

Use of Sedatives and Pain Relief

Symptom control is a vital part of end-of-life care, and carers at Tiggo Care are trained to assist with medications, including those for pain and the management of other symptoms, as dictated by their care plan and medical professionals. Sedation and pain relief might be administered to alleviate symptoms which cause distress, such as agitation.

Advice from Specialist Palliative Care Teams

End-of-life care usually entails complex symptom management and a holistic approach to care. We work with specialist palliative care teams to ensure our end-of-life care plans reflect this. Ultimately, end-of-life care involves a delicate balance between recognising and anticipating changing needs, precision and finding creative solutions to satisfy them.

Documenting Treatment and Care

Record keeping needs to be accurate and timely. At Tiggo Care, our carers record all care activities in a mobile app that can be viewed by relevant members of our team and family members of the patient. Our records include statements about the patient’s condition, their medications, and updates about other activities described in the care plan. By doing so, everyone who is involved in the patient’s care is kept up to date.

Conclusion

Providing care for a person at the end of their life is a big responsibility, filled with emotional and practical challenges. By following the five priorities of care set out by the Leadership Alliance for the Care of Dying People (LACDP), Tiggo Care ensures that the needs and wishes of dying people and their loved ones are met with compassion and respect. Our dedicated team of carers is here to support you and your loved one every step of the way, ensuring that your loved one spends their final days in comfort and dignity.

The five priorities of care outlined by the Leadership Alliance provide a robust framework for delivering high-quality end-of-life care. At Tiggo Care, we are committed to upholding these principles, ensuring that our care staff provide compassionate end-of-life care, which respects the dignity and wishes of each individual. Our approach is holistic, addressing the physical, emotional, and spiritual needs of the dying person and their loved ones.

Please contact us today if you’re interested in learning more about how we can support you and your loved one at the end of their life. We can provide the care and comfort they need to make their final days as peaceful and meaningful as possible.