NATIONAL COUNCIL FOR PALLIATIVE CARE
The aim of the report is to be a practical guide to help extend the asset based approach already existing in end of life care into a learning and development model. Part one forms a short summary of the findings of a project that looked at ways to build a more sustainable asset based approach to workforce development and provides detail on what an asset based approach can look like and what factors need to be in place, incorporating lessons learnt, case studies and tips from those who have already explored the approach. It also contains examples of innovative resources that can be used to support learning facilitators. Part two looks at the project brief from which the practical guide originated, the methodology and the underpinning literature. It provides additional case studies and further detail on the work of Dying Matters and Dementia Friends, both networks bringing together communities to support end of life care raising awareness activities, which also offer valuable opportunities for workforce learning and development.
WHAT WORKS WELLBEING
Drawing on the available evidence, this briefing examines what music and singing interventions work to improve wellbeing of adults living with diagnosed conditions or dementia. While there is ample evidence looking at the impact of music and singing on clinical outcomes such as pain management, coping with hospitalisation, coping with symptoms and managing symptoms of dementia, this new evidence focuses on wellbeing for those living with diagnosed conditions or dementia. Specifically, it focuses on self-reported measures of quality of life; life satisfaction; and anxiety or depression. The paper suggests that there is strong evidence that brief music therapy is an effective intervention to support wellbeing of palliative care patients in hospital settings and initial evidence that music therapy can contribute to improved spiritual wellbeing in hospice patients. There is strong evidence targeted, culturally relevant music interventions can decrease depression in nursing students in a college environment and initial evidence that music therapy can alleviate anxiety in undergraduate students. There is promising evidence that targeted, culturally relevant music and singing interventions can enhance mental wellbeing and decrease depression in older people with chronic conditions in residential and community settings and initial evidence that participation in individual personalised music listening sessions can reduce anxiety and/or depression in nursing home residents with dementia and that listening to music may enhance overall wellbeing for adults with dementia. There is initial evidence that participation in extended community singing programmes can improve quality of life and social and emotional wellbeing in adults living with chronic conditions.
This report sets out key steps that commissioners can take in collaboration with service providers to enable people who are approaching the end of life to avoid being admitted to hospital when this is possible and appropriate, as well as enabling those who are admitted to make a transition to a community setting quickly. The report argues that as well as reducing the costs to the NHS, enabling people to stay out of hospital at the end of life can make a significant difference to the experiences of dying people and their families. The report makes a number of recommendations for commissioners, service providers and health and social care staff, including: commissioning the increased provision of 24/7 care in community settings, through care homes and hospices, and community health and social care services that can provide care in people’s homes; commissioning anticipatory prescribing of medicines for people approaching the end of life; using available funding, through System Resilience Groups, the Better Care Fund, and Integrated Personal Commissioning, to improve co-ordination between hospitals and community settings, including hospices, for people approaching the end of life; and health and social care staff identifying carers of people who are approaching the end of life and referring them for local authority assessments.