Palliative and End of Life Care

Not every patient admitted to intensive care survives, and pretending otherwise serves nobody. Where treatment can no longer achieve recovery, the goal of care changes rather than ends. It becomes the relief of suffering, the preservation of dignity, and support for the family through what follows.

This is among the most difficult conversations in medicine and we do not rush it or delegate it.

How these decisions are made

A decision that further escalation would not benefit the patient is made by the senior clinical team, based on the clinical picture, the response to treatment so far, and what is realistically achievable. It is discussed with the family fully and without euphemism, and where the patient's own previously expressed wishes are known, they carry weight.

Deciding not to escalate is not the same as withdrawing care. Comfort, pain relief, hygiene, mouth care, dignity and the presence of family continue and often intensify.

What we provide

• Pain and symptom control, including breathlessness, agitation and nausea
• A calm environment with as much privacy as the unit allows
• Relaxed visiting so family can be present
• Access to a religious leader of the family's faith, at any hour
• Honest, unhurried explanation and time for questions
• Support with the practical steps that follow, including documentation

For the family

You will not be asked to make the clinical decision. Families sometimes believe they are being asked to choose whether a relative lives or dies, and that burden is not one we place on anyone. The clinical judgement is ours to make and to explain. What we ask of you is your knowledge of the person: what they valued, what they would have wanted, and what matters to them now.

Ask us anything, more than once if you need to. Nobody absorbs this kind of information the first time it is said, and there is no such thing as asking too often.