End-of-life care Resources

A new report on palliative and end-of-life care in the community has been published by the Queen’s Nursing Institute (QNI) and Marie Curie.

The report by the two charities is based on a national survey of health and care staff undertaken in 2023. The majority of survey respondents were community nurses. The findings reflect how palliative and end-of-life care is delivered today, and shines a light on the challenges being faced by nurses. People at end of life need highquality
holistic care and support but worryingly, 9 out of ten respondents to the survey reported being unable to meet the needs of the people they care for, or those close to them, at least
in part.

Malignant fungating wounds (MFWs) arise in 5–10% of all cancers. These wounds are distressing for patients, their families and caregivers, with both physical and emotional symptoms impacting greatly on quality of life. Symptoms include severe pain, bleeding, depression, malodour and negative body image. MFWs present considerable challenges in the application and retention of dressings. These wounds deviate from the normal healing trajectory and the theory of wound healing is not always appropriate; they may expand and progress during the terminal stages of a patient’s life. This article discusses the challenges of treating and managing MFWs and presents some practical solutions to the major symptoms. It also looks at dressing choice and pain management — including pharmacological and topical treatments — managing malodour, as well as assessing and addressing quality of life.