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Table 1 American College of Critical Care Medicine key recommendations for improving the care of ICU patients during the dying process: adapted from Clarke et al. [22] and Mularski et al. [23]

From: Quality of transition to end-of-life care for cancer patients in the intensive care unit

1. Patient- and family-centred decision-making
 Involve patient and family in decision-making/discussions as appropriate to the individual; initiate advanced care planning
2. Communication with team/patient/family
 Meet with the multidisciplinary team to plan care; meet regularly with patient and family to review situation and answer questions; sensitive communication
3. Spiritual support
 Regularly assess and document spiritual needs; document offer of spiritual support
4. Emotional and practical support
 Open visitation for family; provide support and written logistical information (e.g. accommodation); financial and bereavement advice
5. Symptom management and comfort care
 Assess symptoms before and after interventions; follow best clinical practice using pharmacologic and non-pharmacologic means for best symptom management
6. Continuity of care
 Maximise continuity of care for patients; introduce new clinicians
7. Emotional and organisational support for intensive care unit clinicians
 Support and educate staff on the ICU who are caring for dying patients