End of life care is more specific than hospice care. Hospice care is appropriate for terminally ill and chronically ill patients. Both will need certain levels of assistance but the individual’s specific needs would vary considerably. Terminally ill patients are often told how long they have and their end of life care must be planned accordingly. There are many priorities that should be addressed while planning end of life care. Here are five broad priorities that would cover everything that is of quintessence.
• The first priority is to recognise the fact or possibility that a person might die in a few days. It could be a few hours or a few weeks. Terminally ill patients can live for months. The time available or what the doctors estimate should be taken into consideration while planning end of life care. The patient must be involved in this process so one can choose what they would like to do and how they would like to spend their days. These needs or desires should be reviewed routinely. The wishes may be revised from time to time and some may have to be altered depending on the developing circumstances.
• The second priority is communication. This includes communication between the terminally ill person and the staff as well as communication between the patient and the family. All should be on the same page before commencing end of life care. The person should be able to communicate with the caregiver. If this is not possible, then the family should have lucid communications with the nursing staff.
• The scope of end of life care will depend on the needs of the patient. A patient may or may not be in a position to communicate so the sharing of information will have to be worked out accordingly. Some people do not wish to be told how many days they have and some people want to be in control. The third priority of end of life care is involvement of all those who are important. This may include family and friends. This may also involve a larger social circle if that matters to the dying person.
• The fourth priority is support. These are in no particular order of significance but just how chronological they are when you plan and initiate end of life care. Support has to be physical, emotional and social. In some cases, people need spiritual assistance as well.
• The fifth priority is to have a holistic end of life care that addresses all other needs of the hour. The holistic plan should cover regulation of symptoms, personalised care, bare minimum intervention of doctors and even nursing staff, daily reviews of the approach and assessment of the effectiveness of end of life care.