Caring for older people at the end of life means focusing on their comfort and quality of life. Nurses and careworkers can play a role in reducing any unnecessary or inappropriate treatments or care that no longer bring benefits and which may now be unpleasant or burdensome for the person.
What I can do
Care as the end of life nears should reflect the older person’s preferences and priorities. You can support this person-centred approach by:
- Advocating for stopping unnecessary diagnostic tests or treatments that do not provide comfort or may cause distress
- Creating care plans that focus on symptom relief, comfort, and overall wellbeing
- Reporting concerns about medication burden to clinical staff.
Therapies aimed at preventing long-term health issues become less important at this time. You might therefore:
- Monitor for side effects from preventative medications that suggest they may no longer be beneficial
- Relax strict dietary restrictions and allow eating for pleasure
- Identify where non-drug therapies may be beneficial and less burdensome that drug-based treatments.
As the older person’s preferences and goals can change over time, regularly check in to see if treatment remains aligned with what they want for their care.
What I can learn
If you wish to learn more about reducing care burden through deprescribing, the following resources may be useful:
What I can give
If an older person, their family or carer is concerned about changes to medications or treatments, these resources may help:
What I can suggest
Strengthen person-centred end-of-life care policies by:
- Ensuring all older people with limited life expectancy have opportunities to express their wishes and preferences for care at the end of life
- Advocating for policies that prioritise comfort, dignity, and individual preferences in care planning
- Improving communication of decisions regarding reducing treatments to all members of the multidisciplinary care team, as well as to the older person’s family and carers.
To build staff knowledge on reducing care burden:
- Provide training on deprescribing, polypharmacy risks, and recognising medication-related issues
- Support staff in effectively communicating changes to care in ways that reassure the older person that care is not being withdrawn
- Ensure staff understand what a Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) involve and how they can be used to optimise medication safety and quality of care.
Page updated 14 March 2025