COVID-19: clinical guidance on end of life care

The Scottish Palliative Care Guidelines have been developed by a multidisciplinary group of professionals working in the community, hospital and specialist palliative care services and provide practical, evidence-based or best-practice guidance (which included peer review), on a range of common clinical issues. These guidelines were first published in 2014, with selective updates to guidelines requiring review in 2019 following the same approach. These guidelines will be of benefit to both generalist and specialist providers of palliative care.

Temporary guidance related to end of life care during the COVID-19 pandemic is found within the Scottish Palliative Care Guidelines. This guidance is intended to be used to support professionals managing patients approaching the end of life in this context. This temporary COVID-19 specific guidance, does not replace existing local and Scottish Palliative Care Guidelines for symptom management, and advice should be sought from your local palliative care team should this be deemed necessary. The temporary COVID-19 guidance was developed through a rapid review of available evidence, expert opinion and expert peer review.

This temporary guidance addresses symptom management for COVID-19

• Guidance for when a person is imminently dying from COVID-19 lung disease
• Guidance for supporting end of life care when alternatives to medication normally given through syringe pumps are required

Standard end of life care guidelines should be used for all other situations.

The temporary guidance also signposts additional non-medicines guidance to support clinicians

• Anticipatory Care Planning (ACP) guidance:
  • HIS Anticipatory Care Planning for COVID-19
  • NES Supporting resources for ACP discussions for professions
• Communications:
  • EC4H COVID-19: Effective communication for professionals

Further resources

• Practical resources to help professionals giving medicines
• Support for professionals and carers themselves
• Signposts to support members of the public through serious illness death and loss

The following guidance on visiting should also be followed:

Scottish Government Coronavirus (COVID-19): hospital visiting guidance

Scottish Government Coronavirus (COVID-19): adult care homes visiting guidance