End of life care
There are no restrictions on time or the number of people who can provide support for loved ones at the end of life. The flexibility and compassion of clinical staff in supporting this throughout the pandemic has been appreciated and this should continue as flexibly as possible.
It can often be difficult to identify when someone may be nearing the end of life and interpretations of ‘end of life’ may differ across clinical settings. As such, it is not appropriate to define a set time period for ‘end of life’ care in this context. Instead clinical teams should adopt as compassionate and broad an approach as possible. “End of life” is not expected to be defined only as the last hours of a patient’s life or when someone has become unconscious. Likewise, as is not infrequently the case, if someone is identified as at the end of their life and then rallies, support from family or carers should not be stopped suddenly, but should be carefully and sensitively transitioned so that support can still continue as described elsewhere in this guidance. This guidance is intended to ensure that patients nearing the end of life can spend meaningful time with their loved ones in the final days, weeks and months of their life.
The Scottish Government endorses the principles set out by the Scottish Academy of Medical Royal Colleges and clinicians may find these helpful when considering how best to support visiting for patients nearing the end of life.
International travel and end-of-life
It is important to note that visiting someone in hospital in an end-of-life circumstance is listed as an exemption to the Health Protection (Coronavirus) (International Travel) (Scotland) Regulations 2020. This means that someone is permitted to leave quarantine after international travel to visit a loved one at end-of-life. This should be managed carefully by the hospital to minimise risk, as follows:
The individual must:
- contact the hospital to arrange a visit in advance
- take a LFD test and receive a negative result
- wear full PPE equipment as advised by the hospital
- ensure good hand hygiene when donning / doffing of PPE
- observe physical distancing from others, but not from the individual being visited
- not visit any other area of the hospital or use facilities such as toilets
- observe any other risk measures as required by the hospital
The hospital must:
- carry out a risk assessment to determine whether a visit can safely take place
- make every effort to prevent other staff, visitors or patients from being in the same area as the person being visited
- support the individual to don and doff PPE
- ensure access to hand hygiene facilities
- enhance cleaning measures in the area visited
- safely escort the visitor in and out of the hospital
If you have feedback on this guidance please email: Annalena.Winslow@gov.scot.
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