Checklist for the last few days of life at home
| Checklist | Yes | No |
| Has the patient's condition been discussed with the carers? | ||
| Has the patient's medication been reviewed and non essential medication discontinued? | ||
| Has appropriate medication been prescribed for pain, agitation, nausea/vomiting and excess secretions? (THE CORE FOUR) | ||
| Has all inappropriate interventions been stopped? | ||
| Is the patient nursed on a high dependency mattress and turned for comfort only? | ||
| Is there a syringe driver available should it be required? | ||
| Are out of hours medical and nursing services aware of the situation? | ||
| Is the carer clear about what medication to give the patient and when? | ||
| Is the carer clear about their role with other nursing care? | ||
| Does the carer know who to contact if the patients symptoms are not controlled? |
Adapted from Checklist for the few last days of life
with
permission from Maureen Brown, Derwentside Primary Care Trust, Co.
Durham.
© Dr. Eileen Palmer, Dr John Howarth Palliative Care for the Primary Health Care Team Quay Books ISBN 1856422291