Manage Dying
What does managing dying look like in practice?
Like with palliative care needs, signs and symptoms of dying, and therefore management of care, will differ between older persons. The Manage Dying page of the ELDAC Care Model provides an overview of what managing dying involves, common symptoms to look out for, the importance of ensuring good end-of-life care for a ‘good death’, and what to do after the older person has died.
At this stage, priority should be given to maintaining comfort and dignity through appropriate symptom control.
What is my role as a primary care professional in managing dying?
Identifying the last days of life and managing dying requires strong clinical judgement that considers both the clinical needs of the older person and also their wishes and preferences for a ‘good death’. Clinicians in primary care, through their ongoing and trusted relationships with older people [1], are appropriately placed to help achieve this, managing dying in a way that maintains comfort and dignity through appropriate symptom control and coordination of care.
Clear and honest communication with the older person and their family and carer is also central to navigating the dying process [2], including after-death care and associated legal requirements.
We want you to be equipped to:
- Understand your role and responsibilities as a primary care professional in managing the needs of the dying older person.
- Confidently identify when the older person is approaching their final days of life, and reassess their palliative care needs to determine the necessity of current interventions and medicines.
- Manage symptoms of dying in the older person appropriately and in line with their goals of care and/or advance care directives. This may include consideration of the care setting, such as at-home.
- Inform yourself or be familiar with the legal requirements following death within your practicing state or territory, such as verification and certification of a death.
- Consider and prepare for the needs of diverse population groups in the perceptions and practices of death and dying.
- Support the families, friends and carers of the older person by providing information and resources on death, dying, and after-death. This may also include pre-emptive information and resources on bereavement, loss and grief.
The dying patient
CareSearch
Key points for consideration in recognising and then managing a dying older person are identified on this webpage.
Terminal/End-of-life care
CareSearch
This webpage provides an evidence-based summary on what end-of-life care is, why it matters, and what it looks like in practice to help support care delivery.
End-of-life symptoms
CareSearch
This webpage describes common end-of-life symptoms, advice for health professionals, and prescribing information.
Symptoms and Medicines
palliAGED
This webpage describes considerations for symptom and medication management for older persons in the active dying phase of care.
Checklist - Planning for a home death
CareSearch
A checklist for GPs when planning for an expected home death. Main topics include:
- clarifying expectations and support
- assessing the home situation
- planning for symptom management
- information that families need.
Legal protection for Administering Pain and Symptom Relief
ELDAC End of Life Law Toolkit
The End of Life Law Toolkit has compiled information on the law around pain and medication management in end-of-life care to help health professionals protect themselves and practice high quality care.
After-death care
CareSearch
This webpage describes the key actions for consideration following death, to do prior to the older person passing, such as what to expect for family members.
Manage Dying
ELDAC Home Care Toolkit
The Manage Dying section of the Home Care Toolkit provides at-home specific considerations for managing death and dying.
Verification and certificate of a death
CareSearch
This webpage outlines key information regarding the certification and verification of a death for a nurse, including links to state and territory specific information.
Diverse population groups
ELDAC
ELDAC has compiled a series of information for diversity considerations in palliative care across population groups, including; Aboriginal and Torres Strait Islander peoples, Care Leavers, Carers, Culturally and Linguistically Diverse, Financially or socially disadvantaged, Homeless, LGBTI+, Rural and remote, Spirituality and faith, and Veterans.
Caring for diverse populations
ELDAC Primary Care Toolkit
The Support for the older person, family and carer provides additional resources, further education and information on how to identify HealthPathways for diverse populations to support appropriate care.
Support for the older person, family and carer
ELDAC Primary Care Toolkit
This section of the Primary Care Toolkit provides a summary of resources on palliative and end-of-life care to provide to the older person, their family and carer to support them, as well as how to develop feedback mechanisms for ongoing improvement, and providing care to diverse populations.