Sometimes, even with the best care, a person in Critical Care may not improve. This can mean they are nearing the end of their life. We know this is an incredibly sad and difficult time. We are here to care for your loved one - and to care for you.
We will explain what is happening and why, and work with you to make a care plan that focuses on what matters most to your loved one. Some families have known for a while that their relative is very unwell; for others, this may feel sudden. There is no right or wrong way to feel.
Please ask us any questions at any time. We will take things step by step, together. You can find more information about end-of-life care on the ICUsteps website.
When someone is nearing the end of their life, our care focuses on comfort and what matters most to them. Some people have shared their wishes in advance. If not, please tell us what you think they would want - your knowledge of them helps us care in the right way.
Some people have strong wishes about where they want to be at the end of their life - at home, in a hospital, or in a hospice. We will do our best to support these wishes. Sometimes it may not be safe or possible to move someone from the hospital. If this happens, we will explain why and talk with you about the options.
Near the end of life, many people do not feel hungry or thirsty. This is natural. We will offer food and drink for as long as your loved one wants them. If they cannot drink, we keep their mouth clean and moist. If you would like to help with this gentle care, we can show you how.
We regularly review medicines to make sure they are still helping. We also stop any tests or checks that might cause discomfort and don’t improve comfort. Our main goal is to ease symptoms and keep your loved one comfortable.
If your loved one has pain, breathlessness, restlessness, or anxiety, we can give medicines to help. Sometimes we use a small pump called a syringe driver, which gives a slow and steady flow of medicine. This helps keep them comfortable.
People often sleep more near the end of life. They may still hear your voice or feel your touch, even if they do not respond. Speaking softly, reading aloud, playing music they enjoy, or holding their hand can be calming.
If you think they do not seem comfortable, please tell us
If your loved one has religious or spiritual needs, please tell us. Our chaplaincy team can support people of all faiths and none. They can visit the bedside. You may also ask your own faith leader to come. We can help arrange this. Quiet rooms for prayer or peaceful reflection are open at all times.
For more information about our chaplaincy team, please see UCLH Chaplaincy
We may place a small swan sign near the bed. This sign gently lets staff know that this is a sensitive time. It helps us offer quiet, flexible, and thoughtful care. We will only use the swan sign if you agree.
If someone you love has died, the hospital’s Medical Examiner information page explains what happens next and where you can find support.
Each year, our critical care unit holds a memorial service for people who have died in our care. Families and staff come together to remember and reflect. You are welcome to join if you wish. Many people find this a gentle and supportive space.
