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Seriously ill people often want to spend their last days of life at home being cared for by family or friends. This website details how carers, who are looking after a very ill person at home, can be taught to give extra (top-up) doses of medication under the skin to the person they are caring for when they experience ‘breakthrough’ symptoms (that is, symptoms not controlled by their regular medication). This will be in addition to the care they are already receiving.

This website should only be used by carers who have been identified and assessed as being suitable by healthcare teams.

Background Information

  • Information for carers and patients

    Information that outlines how carers can be taught to give extra doses of medication to the person they are caring for when they experience ‘breakthrough’ symptoms.

  • Glossary

    A list of commonly used terms used in end-of-life care.

  • Medication Guide

    A guide for a carer to assist in their understanding of as-needed subcutaneous medications commonly given to people being care for at home in the last days of life.

How to give injections

  • Ampoule Guide

    A step by step guide to opening and drawing up medications from an ampoule.

  • No Needle Injections

    10 step plan for preparing and giving as-needed subcutaneous injections using a no-needle technique.

  • Blunt Needle Injections

    10 step plan for preparing and giving as-needed subcutaneous injections using a blunt needle technique.

For professionals

  • Policy and procedure

    The complete policy for carer-administration of as-needed subcutaneous medication for common breakthrough symptoms in home-based dying people.

  • Structured debrief for carer(s)

    A five question de-brief for carers to capture their experience of administering medications.

  • Package process flowchart

    A flowchart for healthcare professionals from patient suitability through to de-brief.

Other useful information

  • Coronavirus Worst Case Scenario Planning

    In these videos, Dr Justin Amery talks about how to plan for the worst during Covid-19, to give you the best chance of getting the care you wish for at the place you wish for.