End of Life Care

Aim of the Course

This course aims to help frontline health and social care workers provide compassionate, safe and person-centred support to adults approaching the end of life.

It develops the awareness needed to:

1. Understand the principles of palliative and end of life care
2. Recognise changes that may indicate deterioration or dying
3. Support comfort, dignity and individual preferences
4. Communicate sensitively with individuals and those important to them
5. Follow advance care plans and lawful decisions
6. Report symptoms and concerns promptly
7. Provide respectful care before and after death

Scope of the Course

This course is suitable for healthcare assistants, care assistants, support workers, senior carers and similar staff working in care homes, supported living, domiciliary care and related adult care services in England.

It provides awareness and role-appropriate knowledge. It does not qualify learners to:

1. Diagnose that a person is dying
2. Make DNACPR or treatment-escalation decisions
3. Assess mental capacity independently where this is outside their role
4. Prescribe, select or administer anticipatory medicines without the required authorisation and competence
5. Verify or certify death

Learners must follow the individual’s care plan, workplace policies and instructions from appropriately qualified healthcare professionals.

What This Course Covers

The course covers:

1. Principles of palliative and end of life care
2. Recognising changing needs and possible dying
3. Person-centred care and individual priorities
4. Advance care planning and preferences
5. Mental capacity, consent and best-interests decisions
6. DNACPR decisions and treatment-escalation plans
7. Comfort, dignity and personal care
8. Pain and other common symptoms
9. Nutrition, hydration and mouth care
10. Anticipatory medicines and role boundaries
11. Communication with the person, family and care team
12. Emotional, cultural and spiritual support
13. Care during the final days and hours
14. Care after death, documentation and staff wellbeing

Learning Outcomes

By the end of the course, learners should be able to:

1. Explain the meaning of palliative and end of life care.
2. Describe the principles of compassionate, person-centred support.
3. Recognise changes that may indicate deterioration or possible dying.
4. Report changes promptly without attempting to diagnose them.
5. Explain the purpose of advance care planning.
6. Describe how the Mental Capacity Act 2005 applies to end of life decisions.
7. Distinguish an advance care plan from an advance decision to refuse treatment.
8. Explain what a DNACPR decision does and does not mean.
9. Follow documented care plans and professional instructions.
10. Support comfort, dignity, privacy and personal care.
11. Recognise common symptoms requiring professional assessment.
12. Support nutrition, hydration and mouth care according to the person’s plan.
13. Explain the purpose of anticipatory medicines and personal role limitations.
14. Communicate sensitively with the person and those important to them.
15. Respect cultural, religious, spiritual and individual preferences.
16. Provide appropriate support during the final days and hours.
17. Follow workplace procedures after a death.
18. Recognise personal emotional responses and seek appropriate support.

Further Reading and References

1. Legislation: The Mental Capacity Act 2005 establishes the legal framework for capacity, best-interests decisions and advance decisions to refuse treatment. Read the Mental Capacity Act 2005
2. Clinical guidance: NICE Guideline NG31 — Care of dying adults in the last days of life covers recognition of dying, communication, hydration, symptom control and anticipatory prescribing. Read NICE NG31
3. Regulatory guidance: CQC outlines expectations for person-centred, dignified and coordinated end of life care in adult social care services. Read CQC end of life care guidance
4. National guidance: NHS England’s Universal Principles for Advance Care Planning support personalised and lawful discussions about a person’s future care preferences. Read the NHS England principles

Important practice point: A DNACPR decision applies only to CPR. It must never be interpreted as an instruction to withdraw ordinary care, comfort, symptom relief, nutrition, hydration or other appropriate treatment.