The hospice movement has had a major effect on how we look after the terminally ill at home, involving:
- excellent control of pain and other symptoms
- time to talk to the patient and their family
- the quality of life left
- the GP as coordinator of the primary health care team and other carers to ensure flexible and continuous support
- good communication with the on-call doctor out of hours
- extra district nursing, social services and domiciliary hospice nursing resources
- opportunity for the patient to talk about their fears (often they can be swiftly reassured)
- regular review of drugs (keep as simple as possible)
- regular analgesics (more effective than relieving established pain)
- terminal care allowance (complete DS1500 promptly)
ref: N Lawrence et al, HB Emergencies in Gen Pract 2e, 1996