End of life patients should be helped to hydrate


People who are in their final days of life in hospital should be assisted to receive hydration, according to a draft guideline from the National Institute for Health and Care Excellence (NICE). 

It follows the abolition of the Liverpool Care Pathway (LCP) in 2014, the protocol for looking after people at the end of life.

The LCP sometimes involved the withdrawal of food and fluids from dying patients and became a ‘toxic brand’ after media coverage showed some families had been told their loved ones were not on the pathway. 

The draft NICE guideline, which has been published today for consultation, aims to improve the quality of care for people who are dying in hospital.

It says people at the end of life should be encouraged to drink if they wish to and are able to. 

Assisted hydration should be monitored at least once a day, and fluids should be reduced or stopped if there are signs of harm or no signs of benefit. 

The communication needs and expectations of the dying person should be established and a ‘confident and competent’ healthcare professional should discuss the person’s prognosis with them, the guideline also recommends. 

There should be shared decision making, and individualised care plans should be created with the dying person, their family, people who are important to them and a multidisciplinary healthcare team. 

The guideline also lists signs and symptoms to help doctors and nurses to identify when someone is dying, and it details the sort of changes that may indicate if the patient is recovering or deteriorating. 

NICE chief executive Sir Andrew Dillon said: ‘Earlier this year, the Parliamentary and Health Service Ombudsman said that end of life care could be improved for up to 335,000 people every year in England.

‘The guideline we are developing will ensure that people who are nearing the end of their lives are treated with respect and receive excellent care.’     

The consultation on the guideline runs until September 9. 

To read the full guideline, click here