Te Ara Whakapiri (the unifying path): Principles and guidance for the last days of life
Quick-reference documents for clinicians caring for patients in their last hours or days of life:
Anticipatory prescribing flow charts for the five most common symptoms (what medications to prescribe and when/how to use them)
Agitation/delirium/restlessness
Excessive respiratory tract secretions
Baseline assessment and preparation for care after death (checklist)
Symptom management in the last days of life (guidelines including holistic care recommendations and the anticipatory prescribing flow charts, as above)
Ongoing care of the dying person – hospital setting (ACE chart to be completed each shift)
Ongoing care of the dying person – home setting (ACE chart to be completed each visit)
Staff signature sheet (for any staff completing Te Ara Whakapiri documentation)
Discharge checklist (when someone is being discharged home to die)
*Note: these documents were adapted from Te Ara Whakapiri: Principles and guidance for the last days of life (Ministry of Health, 2017) by the South Island Te Ara Whakapiri Workgroup, South Island Alliance, 2020
Te Ara Whakapiri: Principles and guidance for the last days of life (comprehensive background document from the Ministry of Health, 2017
Te Ara Whakapiri: Toolkit (the set of clinical checklists, flowcharts, tools and patient resources to be used for individual patients at the end of life from the Ministry of Health, 2017)
NOTE: some of the resources in this toolkit have subsequently been updated for the South Island and will therefor differ slightly from the MOH documents. See the links above
Recognising the dying person (flow chart)
Medical management planning (general principles)
When death approaches (information sheet for carers)
Dying at home (information sheet for carers)
Bereavement risk assessment tool (checklist for staff)
Further information can be found on the Ministry of Health website: www.health.govt.nz/publication/te-ara-whakapiri-principles-and-guidance-last-days-life
Many thanks to the original MOH team for developing these Te Ara Whakapiri resources, as well as Dr Kate Grundy and the South Island Te Ara Whakapiri Workgroup who subsequently refreshed several of the documents.
Dr Kate Grundy (Chair), Jo Hathaway (Facilitator), Rose Blair, Steph Ash, Vicki Telford, Sinead Blee, Annie Wallace, Amanda Jennings, Nicky Featherstone, Jane Smith, Dr Louise Bremer, Sharon Stewart
Page last updated: 26 April 2024
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