End of life care in the community: the role of ambulance clinicians
Abstract
Ambulance clinicians are frequently called to patients who are approaching the end of their life. This article presents an overview of some of the issues that impact on the delivery of care to patients at the end of life, including symptom and urgent care needs in the last few days of life, preferences for care/place of care and coordination of care. Each of these areas pose different challenges for ambulance clinicians. As a way of addressing some of the issues, this article outlines an online education package in end of life care, which has been specifically designed for ambulance clinicians in response to an analysis of their training needs. The learning outcomes and educational approach is described. The education aims to help equip ambulance clinicians with the knowledge and confidence that they need to deliver high-quality urgent end of life care.
In total, across all ages, places and causes, approximately 1% of the United Kingdom population dies each year (Office for National Statistics, 2010). Most people who are approaching the end of their life will be living in the community with chronic incurable disease (Office for National Statistics, 2009) and deteriorating health. Ambulance crews may attend and provide care to these patients and their families for a variety of reasons including in response to a crisis, for emergency care, and for transportation between different settings (Munday, 2007; Ingelton et al, 2009). The complexity of the care required and the frequency of encounters with these patients means that ambulance clinicians are vital to delivering high-quality end of life care to patients in the community setting (National End of Life Care Programme, 2012a).
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