Palliative and End of Life Care:Collaboration, Compassion, Choice

‘We cannot take away the whole hard thing that is happening, but we can help the burden into manageable proportions’

Saunders, 1963

Some facts……

• Approx. 500,000 people die each year in England

• 1% of the English population dies each year, 75% of these deaths are expected

• About 25% of all hospital beds are occupied by someone who is dying

• More people are dying each year

• 100% of us will die

• Some people experience excellent care at the end of their lives, many do not

• Care staff want the best possible experience for the people they are supporting and caring for

People used to die young. Now they die old.

30

20

10

0

50

40

0-4 5-9y 10s 20s 30s 40s 50s 60s 70s 80+age group/years

% of total deaths in different age groups. Data for the London parish of St Botolph 1583-99, and for England & Wales 1998.

% of totaldeaths

1590 1998

Death used to be acute. Now it is chronic.

Death rates in England & Wales (per 100,000)

Source: ONS 2004

Main causes of death in

past:

Infections

Child birth

Heart

attack

Accident/Violence

Main causes of death inpresent:

Cancer

Heart failure

Stroke

COPD

http://www.cphs.mvm.ed.ac.uk/groups/ppcrg/themes_illnesses.php accessed 20/2/16

Carers Distress (2010)

Challenges – nothing new….??

• Staff stress and resilience

• More and more for less and less

• Self-compassion and care

• Thinking time for you

• Opportunity to reflect, question, share, learn….

• Makes me think that…..

• Small measures/tips

• Common purpose

Nicola Winship – father died of dementia 2015

“I think the key thing for our family was communication and

consistent support from the beginning. Giving the person with the

terminal illness the choice to put wishes in place whilst they are

capable and not being afraid that such conversations are

inappropriate. Every family is different some may never want the

discussion but to be given the opportunity is essential”

Some personal reflections……

Recognising dying….so important

Human kindness…in small and large measure….is never forgotten

Listening to concerns of family….immeasurable impact

“Is it OK with you if…?” “What do you think….?”

Simple things often meant the most…….