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EoL Admission Avoidance PCSP

Supporting a patient’s wishes to remain in their preferred place of care, where clinically appropriate, is essential to providing holistic care and supporting psychological wellness at the end of life.  

When a patient deteriorates, it is essential to have a personalised escalation of care plan agreed so that the patient or their loved ones know whom to contact.  

All patients identified as being in the last days, week and months of life should have contact details for their palliative care support team, whether the district nurse team or specialist community palliative care team who they can contact for advice and support.  

If a patient is being assessed by a clinician in order to prevent an admission, then it is essential that the immediate clinical issue is supported along with a rapid review of the palliative patient’s circumstances, including advanced care and treatment escalation plans in a shared decision-making discussion with the patient’s loved ones / carers.  

It should be ensured by the attending clinician that the patient/ loved ones/ carers understand the most appropriate routes for accessing support if the patient’s clinical situation further deteriorates.  This will enable the patient’s wishes for their preferred place of care to continue to be supported.   

  1. Review the patient’s presenting issue  
  2. Review the support in place for the patient and their carers / loved ones. 
  3. Review the patient’s advanced care plan  
  4. Review equipment need to support care in the chosen place of residence