Recognising Dying

It can be challenging to recognise when a patient is entering their last hours and days of life, and at times that uncertainty may act as a barrier to communication with the dying person and their loved ones.

However, these uncertainties can often be shared as part of an open and honest conversation acknowledging that someone is deteriorating.

Who can recognise that a patient is dying?

Each member of a multidisciplinary team can help recognise a deteriorating patient, and often observations from the patient’s family or the patient themselves are invaluable. A doctor of ST3 level or above should be involved to evaluate whether reversible causes have been excluded, and the patient should be reviewed by a consultant within 24 hours. When we recognise someone is dying: • An individualised plan of care can be made with the input of the patient and their family. • Symptoms can be monitored and managed. • The patient and family can be supported appropriately through a pivotal time. • Unnecessary investigations and interventions can be discontinued. • It gives the patient and their family time to prepare, both emotionally and practically. • It allows spiritual needs to be addressed. • It improves the chance of people dying in the place of their choosing.