New guidance has been published to help ensure that frail older people, including those in care homes and prison settings, receive the care they want and deserve at the end of life.

The guidelines from the British Geriatrics Society were produced over 18 months involving more than 30 contributors with expertise in a wide range of issues which affect older people towards the end of life.

It is the first set of guidance to cover the unique considerations applicable in specific settings, such as urgent care, care homes and prisons. They explore issues such as cultural and spiritual needs, and the importance of social and psychological support.

Too many invasive and distressing treatments 

Professor Tahir Masud, President of the British Geriatrics Society, said: “At the present time it is perhaps more important than ever that considerations and conversations around the end of life are prioritised, to help ensure that older people receive the care they want and deserve. I am confident that this document, which is the first of its kind, will be of enormous value to the multidisciplinary teams who support older people with frailty at the end of their lives. It will help healthcare professionals to navigate older people and their families through this difficult time, providing care, comfort and relief.”

The guidance covers the final year of life of people living with frailty, and addresses key issues such as advance care planning, law and ethics, and management of common symptoms such as pain, delirium, incontinence and swallowing difficulties.

Co-Editor of the guidelines, Dr Eileen Burns, said: “Too often the clinical response to an acute deterioration in a frail older person is protocol or pathway driven, especially during an unprecedented crisis such as the one we are experiencing at the moment.

"This can lead to invasive and sometimes distressing treatments without pausing to reflect on the values and wishes of the older person who is being cared for. Even when the need for end of life care is recognised, its delivery can challenge clinicians. Providing high-quality, person-centred end of life care for older people with frailty must remain a priority for all healthcare professionals, during the current pandemic and in future”