Avoiding inappropriate resuscitation in the last days of life

Resuscitation measures (such as admission to an intensive care unit, ventilatory support or cardiopulmonary resuscitation [CPR]) will not be effective or beneficial in patients who are actively dying, and can be distressing. Ensure documentation about advance care planning, including what to do in relation to resuscitation, is included in the patient’s medical record and shared with the entire healthcare team. Also ensure documentation is available in the location of care in the last days of life, including at home, to avoid inappropriate resuscitation by healthcare professionals (eg if an ambulance is called). For further information, see Communication of an advance care plan.

If resuscitation measures have not been discussed, or the decisions have not been documented before the last days of life, this will need to be addressed. If possible and appropriate, explain the process of dying to the patient and their carer(s) and family, and explain that resuscitation measures will not be effective or beneficial. Reassure them that the focus of care will be on symptom management and keeping the patient comfortable. For difficult or complex situations, seek specialist palliative care advice. For general principles to assist communication, see Overview of communicating with and supporting patients with palliative care needs.

For more information about withholding treatment and resuscitation planning, see Withdrawing or withholding treatment in palliative care.