Clinical Case Database / Category: Clinical Care

Care of the dying patient in hospital

Publication details

Davina Brown MBChB, MRCP, Katie Athorn MBChB, MRCP
Foundation Years Journal, volume 3, issue 9, p.32 (123Doc Education, London, November 2010)


Around half a million people die in England each year and 58% of these deaths occur in the hospital setting. Almost two-thirds of these deaths occur in people aged over 75 and follow a period of chronic illness, e.g. heart disease, cancer, stroke, chronic respiratory disease and dementia (1). However, despite the large number of dying patients that we care for in hospital, evidence suggests that we provide suboptimal care (2,3). This is also reflected by the high number of complaints received by the Healthcare Commission involving issues around death4. Over the last two decades, the relatively new speciality of Palliative Care has emerged with the aim of providing advice and guidance on the medical management of symptoms at the end of life closely linked to a much more holistic approach of providing emotional, social and spiritual support for patients and their carers. The important role of palliative care is also covered in the undergraduate and Foundation programme curricula (in particular, communication skills, breaking bad news, and skills and knowledge supporting DNAR orders and advance directives).

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Davina Brown MBChB, MRCP

ST4 Care of the Elderly Leeds General Infirmary

Katie Athorn MBChB, MRCP

Specialist Registrar Care of the Elderly Leeds General Infirmary


1. End of Life Care Strategy. The Department of Health 2008.
2. M. Mills et al. Care of Dying Patients in hospital. BMJ, 1994, 309:583–586.
3. J. Lynn et al. Perceptions by family members of the dying experience of older and seriously ill patients. Annals of Internal Medicine, 1997, 126:97–106
4. Al-Qurainy R. et al. Dying in an Acute Hospital Setting: the Challenges and Solutions. International journal of Clinical Practice, 2009, 63:508–515.
5. Age Concern
6. National Council for Palliative Care
7. Coventry P.A. et al. Prediction of appropriate timing of palliative care for older adults with non-malignant life threatening disease: A systematic review. Age and Aging, 2005, 34:218–227.
8. The Marie Curie Palliative Care Institute Liverpool
9. Inquiry into Palliative care in England. The House of Commons Health Committee.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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