Colleen Brothers, Manager at Bluebirds Neurological Care Centre in Milton Keynes, run by PJ Care
As Manager of Bluebirds Neurological Care Centre, the Gold Standard Framework’s ‘Home of the Year’, Colleen Brothers has an award-winning approach to end of life care. Here, she explains the importance of kindness and support for families when treating residents approaching the end of their life.
End-of-life care can be complex, as it is not just about the clinical side, in making a person as comfortable as possible, but also the human side, especially for the family of the person nearing the end of their life.
At Bluebirds, we look to get everything right about end-of-life care from a clinical side, such as making sure we have good symptom control. One of the big things about the Gold Standards Framework (GSF), which we follow here, is that with end-of-life care nothing comes as a surprise; everything is planned and in place ahead of time and you know you are following a person’s wishes as much as you can.
That is about being well organised and well planned, but we also look to build up relationships with families. We talk to families about what their loved one does or doesn’t want as our residents by the time they come to us are beyond being able to do that because of their brain injury or dementia. We explore that with family or friends to find out about who they were, what they liked, what their belief system was to help them to think about what was important to that person. We do that for all our residents.
But above all, our approach comes down to kindness. It covers everything; if a person is essentially kind by nature, they are going to be patient, supportive, respectful, want to be knowledgeable, open and honest and gentle. A kind person covers everything we need.
This approach runs through the team, from nursing staff to housekeepers and maintenance personnel. After all, when supporting families, it may be a member of the housekeeping team that strikes up the trusting relationship or might share an experience that resonates with the relative, it is not necessarily going to be the nurse that can offer the most support to somebody.
This approach helped us through the Covid pandemic. We maintained an open door policy for end of life care, even when everything else was in lockdown. Whether it was bringing people in through the back door instead of walking through the unit, providing practical support to family members such as three meals per day, somewhere to sleep if needs be or access to a shower.
We also give family members swipe cards so they can let themselves in as they please, which some really appreciate as they literally can move in for a week when their loved one is reaching the end of their life.
Obviously, they had to have daily lateral flow tests and regular PCRs, as well as change into scrubs, wear the same PPE as we did on the ward – essentially it was like they were a member of staff coming into work every day.
To keep this going, even when many other providers excluded relatives during lockdown periods, was incredibly important for our relatives – the value of being with their loved one at the end cannot be measured. It was hard to make it work but careful planning with the families ensured that it did.
What happens after a resident has died is important too. We complete a significant event analysis. This involves the whole team; it is an open forum where we are honest and ask staff what things we thought we did well and not so well and what we could do better in the future and learn from this? It is a chance for staff to talk about how they felt about things. Staff do get upset when a resident dies, and this natural, but this can help.
We are always learning at Bluebirds, as we seek to ensure that all residents have the best possible support as they reach the end of their lives.