Multidisciplinary team meetings are a key part of stroke unit care. Most teams meet at least weekly, sometimes daily to have brief, focussed discussions about future care. These meetings are important opportunities to make decisions about end of life care.
It is important that each team member comes to the meeting with information about how each patient is progressing and any interactions with families which may influence end of life decisions or care and be prepared to talk about this. During the meeting it is important for everyone to have the opportunity to have their say even if you agree or disagree.
Finally it is important that the outcome of the meeting is clearly documented in the notes so that other staff who were not present can quickly find out about the agreed actions.
At the end of the discussion about each patient, ensure that decisions are documented clearly and specifically. For example:
- No intravenous fluids
- No antibiotics
- Oral feeding and thickened fluids accepting the risk of aspiration
- No further observations
- The rationale for the overall strategy. Note that the rationale for decisions (as well as the decisions themselves) will form the basis of subsequent discussions with the families
- Document whether decisions are still pending e.g. ‘will review next week whether to discontinue NG feeding’
- Also note who will be responsible for contacting the family to discuss the decisions made by the team
Ensure that families’ current concerns are discussed. These may be immediate issues such as pain or dry mouth, as well as discussing longer term plans.
Page last reviewed: 16 Jan 2023
