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British medical bulletin · Dec 2014
ReviewCare of the dying: how do we replace the Liverpool Care Pathway?
- Charles Davis and Jon Tomas.
- St Richard's Hospice, Worcestershire, UK charliedavis@doctors.org.uk.
- Br. Med. Bull. 2014 Dec 1;112(1):5-15.
IntroductionDeath is an inescapable certainty of life. Variability in care for dying persons, however, is present. The Liverpool Care Pathway (LCP) sought to guide care for the last days of life but was phased out after intense scrutiny.Sources Of DataA governmental report and rapid review of evidence were considered alongside mass and social media reporting. An evidence review of end-of-life care was undertaken.Areas Of AgreementAny person's death is inherently challenging. Much consideration must be given to holistic needs when approaching death. Communication skills may be lacking for professional and patient alike.Areas Of ControversyThe LCP became flawed in use rather than intention or principle. Seeming financial gains from death were concerning to all.Growing PointsWe have responsibility for making choices prospectively in order for them to influence our care when we are dying. Normalization of death is key on both micro- and macro communication levels.Areas Timely For Developing ResearchPerceptions of relevant terminology; review of the definition of dying; improved recognition of the dying process and measuring the impact of communication skills training.© The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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