Assessment of End-of-Life Care Provided on a Geriatric Ward over an Eight-Month Period

Abstract Background Palliative care is an interdisciplinary medical caregiving approach aimed at optimising quality of life and mitigating or reducing suffering among people with serious, complex, and often terminal illnesses. In 2022, BMJ Supportive and Palliative Care published “Help for non-specialists assessing EOLC” to support both non specialist consultants and non-consultant hospital doctors in the recommended standards around dying in hospital. This audit aims to assess whether these standards were met in a specialist geriatric ward over an eight-month period. Methods Patients who died on this geriatric ward in the period 24/04/2024–06/01/2025 had their medical charts assessed for documentation of recognition of dying, communication around dying, palliative interventions and management, and palliative care involvement. This data was assessed for any evidence that recommended standards were neglected. Patients discharged home to die or transferred to hospice were excluded. Results Of twenty-four identified deaths, sixteen charts were available. Eight patients experienced gradual deterioration; all had documented recognition of dying, treatment escalation plans, DNACPR orders, symptom management, and palliative team involvement. However, communication with patients was documented in only 75%; with families in 87.5%. Spiritual care was addressed in 25%, and only 12.5% had documented exploration of personal values or wishes. In contrast, among the eight patients who died suddenly, only 37.5% had documented recognition of dying. Half had treatment or advance care plans; 75% had DNACPRs. Symptom control and communication were inconsistently documented. No cases showed evidence of exploring patient wishes, and spiritual care was noted in just 25%. Conclusion Patients who deteriorated gradually generally received care aligned with guidelines, though spiritual and values-based components were lacking. Care for sudden deaths showed significant gaps in recognition, communication, and documentation. These findings highlight the need for improved consistency in EOLC, particularly regarding communication and holistic patient support.