Policy

End of life care broadly refers to care of persons with a terminal illness or condition that has become advanced, progressive and incurable. The Department of Health’s End of Life Care Strategy 2008, states that although every individual may have a different idea about what would, for them, constitute a ‘good death’, for many this would involve:

• Being treated as an individual, with dignity and respect;
• Being without pain and other symptoms;
• Being in familiar surroundings; and
• Being in the company of close family and/or friends.

The report states that many people experience unnecessary pain and other symptoms, are not treated with the dignity and respect and do not die where they would have wished to.

The Care Worker Agency & We Care’s end of life policy will take account of this national guidance to ensure that the needs of customers who are dying are sensitively addressed and agreed within the plan of care including any preferences or wishes they may have relating to their care. This will be irrespective of age, gender, ethnicity, religious belief, disability, sexual orientation, diagnosis or socioeconomic deprivation.

The priority for The Care Worker Agency & We Care  is to promote the dignity and comfort of the customer at all times and to alert other professionals where required if it is believed that other end of life care needs have to be addressed (such as pain relief).  

The services provided by the company will try to ensure and maintain the person’s wishes to remain for example in the comfort of their own home with the right support mechanisms in place. We will do this by working in partnership and communicating well with other people, professionals and agencies involved in the person's care.

The company and our employees will also try to provide whatever emotional and other support is required within the remit of our service objectives, to the individual and their families and friends.

Procedure

1. Everyone has different needs, but some emotions are common to most dying people and can include fear of abandonment, fear of being a burden, concerns about loss of dignity and loss of control. Care and support workers can provide some comfort by keeping the person company, talking, reading to them or just being with the person.
2. Staff should allow the person to express fears and concerns about dying, such as leaving family and friends behind and be prepared to listen and reminisce about the person's life. Ask if there is anything you can do and respect the person's need for privacy.

3. Staff should be aware of the changing emotions of the customer who is at the end of life. The emotional impact of such an event on both the individual and their relatives is great and it is important for staff to try to maintain some kind of routine and structure to help all involved.

4. Other professionals may be involved such as the general practitioner and palliative care and/or community nurses. The Care Worker Agency & We Care will work in partnership with the other professionals to ensure a consistent and well planned and coordinated service for the customer. It is not within the remit and role of care workers to undertake health care tasks for example administer certain types of pain relief and relevant health care professionals will be responsible for this aspect of care.

5. Staff should be vigilant for any signs of discomfort and pain. The person may be prescribed pain relief for example and concerns around a customer’s discomfort and welfare must be immediately reported to the care manager who will contact the relevant health care professionals. The customer should be kept as safe and comfortable as possible.

6. People who know that death is imminent frequently work through a wish list of things they want to do.  This may be about seeing (or talking to) old friends for one last time or it might be spending time sitting in the garden.  It is therefore important that care should be as flexible as possible and sensitive to personal, cultural and spiritual values, beliefs and practices of the individual customers. The care plan should reflect those wishes and choices and all documentation must be reviewed and updated as necessary to continue to reflect changing needs/requests.

7. Care workers must not force their own beliefs or support mechanisms onto a customer.  In particular any religious beliefs must come from the customer and not from the care worker. If a customer requires help to follow their chosen cultural, faith and social lifestyle preferences then the registered manager of The Care Worker Agency & We Care will ensure appropriate guidance and support is provided.

8. The Care Worker Agency & We Care acknowledges that employees must be carefully chosen and specifically briefed to take on such a role and as such, staff will have had or will receive training in caring for customers who are dying.

9. It is recognised that some staff may find caring for customers who are dying or have died an emotional experience and regular ongoing support from the registered manager and franchisee principal will be available to those staff members at all times.  

10. Customers may find it difficult to express their wishes or concerns about what they want now and in the future. This may be especially important for customers who are lacking or will lack capacity to ensure their needs will be met/provided as they would want it. Advocacy services may be required to advise them on their options i.e. preparing a ‘living will’ and what is available to them. Information on how to access these services should be provided by the registered manager if requested.

Related policies:

Confidentiality

Care planning

Consent and customer involvement

Dignity

Equality and Diversity

Reviews

Risk assessment

Reviewed April 2025 by Fay Townsend-Jackson