Liverpool Care of the Dying Pathway

The Liverpool Care of the Dying... Pathway [http://www.mcpcil.org.uk/liverpool_care_pathway] is an outline of care which a patient can expect in the final hours and days of life. It aims to guide members of the multi-disciplinary team in matters relating to continuing medical treatment, discontinuation of treatment and comfort measures during the last days and hours. Its main emphasis is uniting professional support in the fields of physical treatment, psychological support, support for carers and spiritual care. The Liverpool Care Pathway is organised into sections ensuring that evaluation and care is continuous and consistent. Professionals using the Pathway need to ensure that both patient and carers understand that the structure and focus of care has now changed and the focus is now on care and comfort during the end stages of life.

The pathway was developed to act as a guide only. It was never intended to replace the skill and expertise of a health professional. It provides the practitioner with specific prompts to act upon, and aims to alleviate symptoms and to keep patient comfort at an optimum level. Its lack of complexity, and ease of use makes the structure amenable to all health disciplines.

The Liverpool care pathway was developed between the Royal Liverpool hospital and Marie Curie hospice in order to transfer best practice in the dying phase from hospice to hospital. The document has an annual review by the multidisciplinary steering group who review the latest evidence and feedback from uses of the pathway to ensure that it remains up to date and current.

According to the National Mortality Statistics 2004 [http://www.statistics.gov.uk/downloads/theme_health/Dh2_31/DH2No31.pdf] only 16% of cancer deaths and under 5% of non cancer deaths occur in a hospice. Bearing this in mind, therefore, it is essential that a person experiences the same level of nursing expertise at the end of life regardless of their chosen environment.

References

*Ellershaw J (2007) Care of the dying: what a difference an LCP makes. "Palliative Medicine" 21:365-368