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Care of the dying: how do we replace the Liverpool Care Pathway?
1St Richard's Hospice, Worcestershire, UK charliedavis@doctors.org.uk.
Introduction:
Death is an inescapable certainty of life. Variability in care for dying persons, however, is present. The Liverpool Care Pathway (LCP) sought to guide care for the last days of life but was phased out after intense scrutiny.
Sources Of Data:
A governmental report and rapid review of evidence were considered alongside mass and social media reporting. An evidence review of end-of-life care was undertaken.
Areas Of Agreement:
Any person's death is inherently challenging. Much consideration must be given to holistic needs when approaching death. Communication skills may be lacking for professional and patient alike.
Areas Of Controversy:
The LCP became flawed in use rather than intention or principle. Seeming financial gains from death were concerning to all.
Growing Points:
We have responsibility for making choices prospectively in order for them to influence our care when we are dying. Normalization of death is key on both micro- and macro communication levels.
Areas Timely For Developing Research:
Perceptions of relevant terminology; review of the definition of dying; improved recognition of the dying process and measuring the impact of communication skills training.
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