Care homes told to ensure relatives and residents talk about end of life plans

End of Life Care

Care home managers are being urged to consult closely with family members about end of life decisions after it was revealed that up to 40,000 patients every year have do not resuscitate orders imposed on them without relatives being told.

A national audit of 9000 dying patients carried out by the Royal College of Physicians has found that one in five families were not informed that a DNR order had been issued, equivalent to relatives of 40,000 end of life patients being kept in the dark.

RCP estimates that there are more than 200,000 patients per year issued with DNRs that instruct doctors not to attempt cardiopulmonary resuscitation if the patient suffers a cardiac arrest or stops breathing.

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Professor Sam Ahmedzai, chairman of the audit and author of recent guidelines on care of the dying, said in an interview with The Telegraph: “When a decision has been taken [not to resuscitate], it is unforgivable not to have a conversation with the patient – if they are conscious and able – or with the family.

“If a doctor was dying they would expect this. We need to show the same respect to our patients.” he said.

Prof Ahmedzai also said doctors also needed to be far more open with patients who were facing death, particularly in care homes. “Not enough people are being told that there are biological indications they may be nearing the end of their lives,” he said.

“The medical input into care homes is not good enough round the country – sometimes really abominable”

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