A new quality standard published by the National Institute for Health and Care Excellence (NICE) has recommended that people approaching the end of life should be asked about their wishes, including any spiritual beliefs, as an essential part of their care. Although many care providers are proactive in collecting information about people’s wishes, the Royal College of Physicians End of Life Audit for 2016 found that spiritual wishes were only recorded in one in seven of those people able to communicate their needs.
The new quality standard states that “adults in the last days of life, and the people important to them, should be given opportunities to discuss the care they want to receive” and that this should include asking the person where they want to be cared for and if they have any cultural, religious or social preferences that need to be taken into account.Following the publication of the guidance, Sam Ahmedzai, Emeritus Professor of Palliative Medicine and specialist member of the NICE quality standard committee, said “Control of pain and other distressing symptoms is very important for dying people, but good end of life care goes far beyond that”. Professor Ahmedzai added that good care should include asking about the dying person’s spiritual, cultural, religious and social preferences and stated “Only by attending to these issues and concerns can we deliver truly individualised care for each person and those important to them.”
5 Steps to Fulfil People’s Spiritual Wishes
- Plan ahead: Too many care services leave it too late to plan effective end of life care, waiting until the person in their care is seriously ill. Make end of life care planning part of your pre-admission assessment. Even if the person is well at this stage, starting to collect information about the person’s wishes opens a dialogue that can be built on over time.
- Keep a record: Every person in your service should have a record of their wishes and preferences in relation to their end of life care. If you don’t already have one in place, develop a specific end of life care plan that clearly explains the person’s wishes so that you are always ready should their condition deteriorate unexpectedly.
- Review regularly: In some cases, end of life care plans developed at the time of a person’s admission to a service are not actually reviewed until the person is close to end of life. In these cases, information may be out of date or the person’s wishes may have changed. Ensure that any end of life plan is reviewed regularly, in collaboration with the person and, if appropriate, their family, to ensure it continues to reflect their wishes.
- Share the information: Working with GPs and other professionals is an essential part of successful end of life care and it is important to ensure a consistent approach. With the person’s permission, share the content of their end of life care plan with other professionals involved in their care so that they can be sensitive to their wishes and work with you to meet the person’s needs in the most effective way.
- Find out more: Read the full NICE quality standard to find out about the recommendations in fullhere.