CODE 1 Stable phase The patient's symptoms are adequately controlled by established management. Further interventions to maintain symptom control and quality of life have been planned. The situation of the carer(s)/family/friends is relatively stable and no new issues are apparent. Any needs are met by the established plan of care. CODE 2 Unstable phase The patient experiences the development of a new problem or a rapid increase in the severity of existing problems, either of which require an urgent change in management or emergency treatment. The carer(s)/family/friends experience a sudden change in their situation requiring urgent intervention by members of the multidisciplinary team. CODE 3 Deteriorating phase The patient experiences a gradual worsening of existing symptoms or the development of new but expected problems. These require the application of specific plans of care and regular review but not urgent or emergency treatment. The carer(s)/family/friends experience gradually worsening distress and other difficulties, including social and practical difficulties, as a result of the illness of the patient. This requires a planned support program and counselling is necessary. CODE 4 Terminal care phase Death is likely in a matter of days and no acute intervention is planned or required. The typical features of a person in this phase may include the following: - Profoundly weak
- Essentially bed bound
- Drowsy for extended periods
- Disorientated for time and has a severely limited attention span
- Increasingly disinterested in food and drink
- Finding it difficult to swallow medication
- This requires the use of frequent, usually daily, interventions aimed at physical, emotional and spiritual issues.
The carer(s)/family/friends recognise that death is imminent and care is focussed on emotional and spiritual issues as a prelude to bereavement. |