End of life care

About

End of life care is care provided in the last 12 months of life. Doctors, nurses, therapists and other healthcare professionals work together to support the preferences and priorities of the person who is dying. This can also include supporting their family or people important to them through the last phase of the patient’s life and into their bereavement.

Palliative care is clinical care that is focused on meeting the holistic needs of a person with a life-threatening or life-limiting illness. For example, a person living with cancer may decide to stop curative treatment such as chemotherapy, whether or not they show signs that they are at the end of their life. Palliative care is not necessarily end-of-life care, though our palliative care team supports patients who are dying.

The palliative care team offers an advice and liaison service across our hospitals. We do not offer palliative care beds.

What to expect

When you or someone important to you are dying, someone from our hospitals will come to speak with you about your wishes for treatment in the coming months, weeks or days. This could include:

• advance care planning
• specialist palliative care
• CPR and treatment escalation
• care of the dying
• eating and drinking in advancing illness.

You are welcome to include carers or people close to you in these conversations. Alternatively, you may wish to discuss these things with your care team alone. Our chaplaincy and faith services are also available to offer support.

Purple butterfly model of care

The “purple butterfly” model of care helps us ensure we give compassionate care to those who are dying. This approach was developed with patient and people important to them.

You may see a purple butterfly symbol on a ward or just outside a room at one of our hospitals. It signifies to staff, patients and visitors that a person nearby may be in their last hours and days of life. It is a reminder to be mindful of others and conduct ourselves in a manner that embodies care and compassion, and to respect privacy.

If you or someone important to you are at the end of life, staff may ask whether you wish to have a purple butterfly near your bed. The approach is simply intended to ensure you receive the additional support and care required at this challenging time.

Leaving hospital at the end of life

If a patient in hospital is very close to the end of their life and has said they want to die at home, the care team may be able to arrange a rapid discharge.

The hospital care team can work with social care to quickly build a plan and prepare equipment required to keep the individual comfortable at home. This could be a hospital bed and mattress, for example.

If you or someone close to you are in hospital and are concerned about dying in hospital, speak to your care team.

Support after death

Our hospitals offer practical support for relatives and those close to patients who have died. This includes support from the patient affairs team, the medical examiner’s service, help obtaining the medical certificate of cause of death, and information about how to register a death.

Learn more about support following a bereavement.

Further online resources

You can find more information about end-of-life care, including local resources, at the following links:

• HPAL: palliative care resources for patients, carers and clinicians in west London Hammersmith and Fulham | Medindex: HPAL
• End-of-life care | NHS.uk