Te Ara Whakapiri: Principles and guidance for the last days of life outlines the essential components and considerations required to promote quality care at the end of life for all adults in New Zealand. It also provides examples of useful approaches and tools that will serve as aids for the development of national and/or local resources as part of implementation.
The guidance document is based on an extensive evaluation of the available literature and is informed by local research. This ensures it is applicable to the unique context that is Aotearoa New Zealand.
The document has been endorsed by key professional health organisations in New Zealand. It marks a major step towards ensuring that all health care services across the country are focused on delivering the very best care for people who are dying and for their family/ whānau whatever the setting.
The accompanying Te Ara Whakapiri: Toolkit is a set of checklists, flowcharts, tools and patient resources to be used for individual patients at the end of life. It includes:
- a baseline assessment and care-after-death checklist (Care in the Last Days of Life)
- ongoing plans of care (Ongoing Care of the Dying Person to be used in health care settings and Home Care in the Last Days of Life to be used in the person’s home)
- the Recognising the Dying Person Flow Chart
- a list of principles for general medical management planning (Medical Management Planning – General Principles)
- the Bereavement Risk Assessment Tool
- a Discharge Checklist (for people going home to die)
- symptom-management flow charts (covering pain, agitation, delirium and restlessness, nausea and vomiting, excessive respiratory tract secretions and dyspnoea/breathlessness).
The toolkit also includes information for patient/family/whānau as needed:
- When Death Approaches
- Dying at Home.
Clinical notes should be used to document significant information from the assessments and care after death to ensure clear communication for all those involved in the delivery of care.
There is also a staff signature sheet that helps identify all staff who are using the checklists and plans of care in relation to caring for a particular person.
This edition is unchanged except that sections C and D have been removed. These sections contained examples which have since been superceded.