Dying well at home: the case for integrated working
Practice example 10: The Amber Care Bundle
The Amber Care Bundle is a staged process in which a person who has had a stroke is supported to make their wishes and preferences about end of life known. It is not about stopping treatment but about identifying and carrying out what the person wants in a timely and pre-planned manner. It also keeps the patient and their relatives or carers up to date with what is happening, ensuring that staff talk to patients and those close to them about treatment options and where they want to be cared for.
Taking the Amber Care Bundle approach, a number of key decisions have to be made, including whether or not the person wants cardiopulmonary resuscitation and what they want to happen if they become unwell. This approach emphasises the importance of involving patients in decision making, allowing time for consideration and in line with their assessed mental capacity on a daily basis.
The approach is being piloted at the Royal Bournemouth Hospital where patients in the end stages of life following stroke are referred to the palliative care team. The ward team of therapists and nurses work with the palliative care team, care agencies and families/carers to give education and condition-specific information and handling advice/equipment. Therapists give information on activities of daily living that the patient is able to participate in and how best family/carers can support them to do this.
The neuro-therapy team offers telephone support or home visits after discharge, usually in the first few weeks to aid transition to community teams.
Louise Clark, Senior Occupational Therapist, Royal Bournemouth Hospital.