‘Not the obvious pub discussion’. Practical support – planning for end of life care

Featured article - 09 May 2016
Pamela Holmes, SCIE Practice Development Manager

Head-shot of the author, Pamela Holmes, SCIE Practice Development Manager

The Care Quality Commission has just published A different ending - addressing inequalities in end of life care. It looks at ten specific groups including older people and people with dementia. This thematic review also looks at the barriers that prevent people with the poorest experience of care from receiving good quality, joined-up care at the end of their life. One of its findings is that difficulty in identifying the last 12 months of life for people who have conditions other than cancer. This means that health and care staff often do not have conversations about end of life care early enough.

Predicting when someone is going to die is impossible, irrespective of whether someone has cancer or some other life-threatening condition. Ask any palliative care specialist. She or he will confirm that knowing when someone with a terminal diagnosis will die is impossible to know with certainty. There are examples of people who have lived days, weeks, months and even years beyond ‘what the doctors thought would happen’ and others who have declined more quickly than anyone would have expected.

Research by Royal London Insurance finds that 69% of people who lost a partner were financially or practically unprepared for the loss. While death is a certainty we all face, only 11% said that they felt both financially and practically prepared when they lost their partner.

To help prepare financially and practically start a conversation with your partner and find out things like:

  • Agree a shared place for all information, from mortgages to bank accounts, and consider putting bills and accounts in both partners’ names
  • The list of tasks you each carry out
  • Ask your partner the question “if I died could you…” organise the car maintenance, carry out household chores or pay the utility bills
  • Does your partner have a will? If so, is it up to date to reflect changing circumstances?
  • Does your partner have any insurance policies or a funeral plan in place? What are you and your partner insured for and will this be enough? Where might you want to consider further cover?

Dying Matters Week – this week - is also important for those of us who work in the field of social care, to recognise the importance of talking about death and dying, irrespective of age or stage we are. Because it affects our own lives and relationship as well as those we support in our work. We must be part of that important drive to talk more openly about death and dying. We can lead by example and start to talk to family and friends what we would like to happen at the end of life for ourselves.

We can ask questions such as where we would like to die or we want to be buried or cremated; and so on. It will generate all sorts of conversations and raise all sorts of questions we may not have thought through at all. But we will have started the helpful process of bringing death and dying out of the shadows. OK, it’s not the obvious pub conversation but it’s an important one. And while you’re at it, think about writing your will. Too many of us die intestate and that’s not helpful for anyone.

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