What can I do?
Use the SPICT Tool (315kb pdf) to identify people whose health is deteriorating so that care can be planned proactively. SPICT4ALL (317kb pdf) can also be used by people who prefer less ‘medical’ language.
The End-of-Life Essentials checklist (456kb pdf) is also useful.
Talk to people early while they are able to make decisions and their condition is stable, about how to manage unexpected crises.
Encourage adults in your care to include in their Advance Care Plan (ACP) or Advance Care Directive (ACD) what they would want to happen in an emergency.
Easy access to the Advance Care Plan (ACP) or Advance Care Directive (ACD) in an emergency is useful. Ensure that contact details are up-to-date for the substitute decision-maker, the emergency contact and the next-of-kin; this may not be the same person.
Encourage carers to complete an Emergency Care Plan (117kb pdf) and carry a Carer Emergency Card.
Check you know who to contact in a particular emergency situation.
Use this form (928kb pdf) to help you prepare and conduct a conversation with a GP when you are concerned about a resident’s health.
If the person is being cared for at home, consider the GP Checklist Planning for a Home Death.
Observe and note possible stressors or predictors of a behavioural crisis in people with dementia. Remember an infection or adverse drug reaction may be one of these.
Confirm with GP whether anticipatory prescribing could be beneficial to avoid an emergency or to respond to one. The palliAGEDgp app (available as an app or as online content) can help provide anticipatory prescribing.
Before organising a hospital transfer, confirm the client’s or resident’s wishes. If the person cannot express their wishes, refer to the Advance Care Plan (ACP) or Advance Care Directive (ACD) and/or contact the substitute decision-maker and/or key family member(s).
Ensure that the current care plan and documents such as an ACD go with a client or resident when he or she is transferred in an emergency.
After a health emergency or unplanned hospital admission, review the care plan and ACP/ACD. A discussion with the family may be helpful.
Visit CarerHelp to find useful resources for carers.