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End-of-life referral — DGM MCQ

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ModerateEnd-of-life careEnd-of-life referralDGM

An 87-year-old woman with advanced renal failure has complex pain, pruritus and family conflict about place of care. Her GP has adjusted simple measures but symptoms remain difficult. She wants to avoid hospital if possible. Current medicines include opioids, laxatives and antihistamine. What is the most appropriate referral?

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Correct answer: B — Specialist palliative care team

Complex symptoms and family conflict in advanced illness warrant specialist palliative care input, including at home where available. Orthopaedics, memory clinic, dermatology alone and no referral do not meet her palliative needs. Specialist palliative care is not limited to hospice buildings.

Reference: NICE NG31