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Nurse prescribing in end-of-life care in the community: meeting patients' needs

11 November 2021
Volume 3 · Issue 11


This article outlines the important role of medicines in managing community-based palliative care in the last year of life, together with the central role of nurses prescribing in this context. The article discusses the key needs of patients and carers managing palliative care medicines in the home setting, which include a requirement for streamlined, rapid access to medicines, as well as information about and support for daily self-management of medicines. The article draws on recent research in the field of palliative care medicines management and highlights the implications for nurse prescribers.

In England, more than half a million people die every year and at any one time, many are living with a life expectancy of less than a year (NHS England, 2021). The 12 months leading to death are often referred to as the period ‘approaching the end-of-life’ (National Palliative and End of Life Care Partnership, 2021). As the population ages and people live longer with multiple long-term conditions, the number of people needing palliative care in this period is set to rise by at least 25% in the next two decades (Etkind et al, 2017). Much of this care will be provided in the community, at patients' homes, and will be delivered by nurses. Many patients also express a preference to die at home. There is evidence to suggest that during the COVID-19 pandemic, the proportion of people expressing a wish to do this increased, because they did not want to be separated from family and friends and feared being hospitalised (Oluyase et al, 2021). This brought to the fore the important role of community-based palliative care. The recently published Ambitions for Palliative and End of Life Care report (National Palliative and End of Life Care Partnership, 2021) reminds healthcare workers that most staff provide care for people approaching death, and therefore palliative care is not just the province of palliative care specialist nurses – all community-based nurses have a role to play. Phillips et al (2020) support this view and assert that all nurses should be able to assess and manage common palliative care symptoms (including anxiety and depression), engage in discussion about prognosis, treatment goals, distress and suffering, as well as advance care planning preferences.

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