References
Getting anticipatory prescribing right in end-of-life care
Abstract
ABSTRACT
There is a growing number of people who need access to high-quality endof-life care in the home setting. This requires timely assessments of needs, ensuring good symptom management and recognising the roles undertaken by carers. For some patients, a range of medications may need to be put in place to relieve end-of-life symptoms, using ‘anticipatory prescribing’. District nurses must ensure that they acknowledge the patient's voiced preferences and be mindful of the safety issues that arise with the supply of controlled drugs in the home. This article highlights the challenges faced by district nurses providing or dealing with anticipatory prescribing during end-of-life care.
The demand for end-of-life care at home is rising, and district nurses have a key role to play in delivering this care. Etkind et al (2017) reanalysed the Office for National Statistics death and population data from 2006–2014 and concluded that about 75% of all deaths in England and Wales presented palliative care needs. Extrapolating these data, they estimated that 25–47% more people may need palliative care by 2040 in England and Wales, not only because of demographic trends but also because of the rising prevalence of long-term conditions and multi-morbidity. At present, 47% of people die in hospital, 23% die at home and 21% in a care home (Bone et al, 2018). Reductions in hospital deaths will increase home and care home deaths and will necessitate suitably qualified nursing staff who can provide high-quality 24/7 care in the community at the end of life.
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