Death remains a taboo subject for many people. Improvements to healthcare and life expectancy mean that we are not exposed to frequent mortality in the same way perhaps as our great grandparents would have been, and many people can reach middle age without experiencing a significant death in their lives.
Fear of facing up to the end of the line means that few people plan for their death. We shy away from discussing how we would like to end our days with our loved ones, for fear of upsetting them and ourselves.
As health and social care professionals, there are many things we can do to ensure excellent end of life care by using advanced care planning tools.
Talk about what will happen
Although many people don’t want to confront the inevitable, encouraging service users and their families to have conversations about what is important to them can ensure they end their days feeling comfortable and at peace. Talk about loved ones, including pets and other responsibilities, and empower the person to tie up any loose ends that may be a concern. Give people the opportunity to discuss their hopes and dreams, including their spiritual needs, and help them to establish how they would like to be cared for in the event of declining health and potential loss of capacity to direct their own care.
Involve families
When a loved one is dying, friends and family want to spend as much quality time with them as possible, and it may seem counter-intuitive to spend that time discussing death. But by involving their loved ones in developing their care plan and advanced care plan, we can ensure that when the time comes, everyone is prepared and the element of fear is removed. It may seem anomalous, but we can create beautiful memories of time spent with a dying loved one, talking, laughing, reminiscing, celebrating a life well lived and talking about issues close to the heart.
Ensure health professionals are kept up to date
After establishing the needs of the service user and involving their friends and families, ensure that all health professionals involved in their care are made aware of their wishes. Develop partnership working and establish lines of communication with GPs, district nursing teams, local clergy and any other people who may be involved, to ensure that the service user’s physical, emotional and spiritual needs are met and their wishes are taken into account.
Train all staff
When a person is approaching the end of their life in a residential care setting , there are many people who may be involved. It’s important to ensure that there is an open and inclusive atmosphere throughout the home, and that all staff – including ancillary staff – are trained in the provision of end of life care. Often, the dying person will chat to the person cleaning their room about any concerns and it is important that they have the skills to respond warmly and appropriately.
Without communication and understanding, death and terminal illness can be a lonely and stressful experience for the person who is dying and for their friends and family. Talking about death, difficult as it is, doesn’t bring it any closer and does create the space for us to find peace and comfort in our final days.
Hayley Rowson de Vares is the registered manager of Sherdley Court in Merseyside, a residential facility run by adult health and social care charity Making Space. Sherdley Court has platinum status in the Gold Standard Framework for end of life care.
