Dying well at home: the case for integrated working

Choosing to die at home

Making sure people have a choice about where they die

You could feel it in her and it was the remarkable increase, again, in her spirits and that’s all I can say. So, no, I had no hesitancy in ... saying: “Yeah, you can come home.” And, as it turned out, it was a wonderful development.’

Carer [1]

Recommendations

Professionals and providers should:

  • Identify people who may be in their last year of life to ensure that they can access palliative care services when they need it.
  • Liaise with all those involved in the care of the person.
  • Support people at the end of life to choose their place of care and/or death.
  • Provide information and support to carers.

Commissioners should:

  • Encourage providers to have a protocol for identifying and meeting the need for end of life care at home.
  • Ensure, wherever possible, that people are enabled to die at home if they wish. Characteristics such as age or condition should not automatically exclude people.
  • Ensure that providers have protocols in place for liaison between disease specialists (often in hospital settings) and primary/community staff.
  • Ensure that support and services for carers are a priority.

Key points from research and policy

Who dies at home

Factors that influence who dies at home

Specific health conditions

Practice example

  • Practice example 4 outlines a scheme to provide bungalows, a homely environment with health services nearby, to people who cannot be cared for in their own home, because either they have no full-time carer at home or their home environment is unsuitable or overcrowded. Having end of life bungalows close together helps service providers.

Downloads

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Available downloads:

  • Dying well at home: the case for integrated working
  • Dying well at home: research evidence