End of life care
Caring for people towards the end of their lives requires a proactive and positive approach to thinking about death and dying. Good support means taking the time to plan and think through how people want to spend their time and what a good death means to people.
Simon Stockton - Strategic Consultant in Health and Social Care
Carol Taylor - Manager, Garth House care home
Vicky Clarke - Contracts Manager, Surrey Continuing Healthcare
Alison Hardy - Manager, Athol House care home
Mary Israel - Activities Coordinator, Athol House care home
Carole Taylor: There are two impressions you'll never ever be able to repeat that's the first impression when somebody meets you for the first time and at end of life when somebody leaves the home, that impression will always stay with the family.
We have our first end of life discussion very soon after admission which sounds very cruel but it's a very good discussion to have early on because emotions aren't as high as they are at the end.
So one of the first things we ask is have you thought about an undertaker which again it's a very sensitive thing to talk about and have you thought about cremation or burial and that's the important things to find out because - and I ex-plain this to families to say we need to know so that at the time things happen and your emotions are very high we can take that away from you and deal with it.
Simon Stockton: Thinking about death is really hard but it's a fact of life for people living in care homes and for people working in care homes and the families of people who live in care homes. And taking a proactive approach to help people think about how they want their end-of-life to be, who they want involved in planning what they want to happen, celebrating their life after they've passed and supporting both the staff and their friends who were living around them to come to terms with that grief it's something that care homes need to look at and find ways to engage with.
Vicky Clarke: There can be staff who are familiar with death and there can be some staff who still find it upsetting perhaps even after many years particularly if they are residents that they've got to know and love as as part of their family so to speak.
To be able to use this tool to maybe sit down and see how they can make things better not just for the resident and the family perhaps also for the staff as well I think this tool would be really important.
Allison Hardy: You can't undertake end-of-life care if you're not prepared to do that as a team that initially that has to be a team discussion about how they feel, what their fears and fantasies are because that's ultimately going to impact on whether you're going to be able to deliver that, because if someone is in final days and final hours you're not going to know that it's going to happen on a Tuesday at 12 o'clock, it could happen at any time and so - and anyone could walk into a room and find someone in distress.
So everyone has got to be on board and everyone has got to be included and feel included in that process.
Really I've never come across anyone who has wanted to talk about end-of-life care and the only way that you can progress that discussion is by having a connection and the trust of the individual and perhaps developing that information over time. And knowing for that person when it starts to raise anxiety for them and you just stop the conversation and perhaps come at it at a different angle.
Carole Taylor: What I've usually found is people are much more aware than you think they are people usually think or know more than than you think they will. So although you still talk about things very sensitively I think you start the conversation and see where where they want it to go.
Everyone is entitled to having a good death so that's pain free, it's comfortable, it's individual. It's on their terms.
Mary Israel: One of the residents actually passed away here. We were very close. Obviously you know you sort of talked about boundaries and things but at the end of the day you formed a relationship with an individual and they saw you as part of their family and I think if somebody wishes to be they have spent their last hours in the home with you with them if you're able to do that then that makes them feel at ease and it makes you feel that you're doing the right thing by that person.
I think as well having somebody that they can trust and somebody that they feel a warmth with and for, having in person that person there towards your end of life is a very rewarding thing.
End of Life Care: Points to Consider
- Be proactive and sensitive in helping people explore what a good death would look like for them.
- Work with families and staff to help celebrate people’s lives.
- Acknowledge the difficulties in adjusting to the loss of someone, and support people in dealing with the impact of their grief.
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