Review the patient's preferred place of death: is it appropriate or possible to transfer the patient to this place?

Review resuscitation status and ceiling of treatment and ensure up-to-date documents are in the medical record.

Consider deactivation of ICD if present: contact the cardiology service.

Review current medications and discontinue non-essential drugs.

Consider plan for management of diabetes: seek advice from diabetes service (see Further reading).

If the patient is unable to take medication by mouth, give essential medications subcutaneously.

Prescribe as required medications for anticipatory symptom control according to local guidelines (Table 110.7).

Decide if artificial nutrition and hydration should be continued.

Encourage oral intake if not harmful to patient.

Discontinue inappropriate interventions (e.g. observations, turning regimens).

Ensure regular care of the mouth and pressure areas.

Assess and meet the spiritual and psychological needs of the patient and those close to the patient.

Find out how those close to the patient wish to be informed of the patient's death.