End-of-life care is the treatment and support given to someone nearing the end of their life so they can live as well and as comfortably as possible. This is also known as ‘palliative care’. When someone has a progressive condition like dementia or cancer, for example, palliative care is an important aspect of their overall care plan. We usually talk about this in terms of the last year or so of someone’s life, but it can be difficult to predict when someone is going to die. For some people end-of-life care may only mean weeks or even days, while for others it could mean a couple of years or more.
You have the right to say where you would prefer to receive care and where you wish to die – at home, in a care home, hospice or hospital. Wherever you are, you have the right to high-quality care. Your wishes will be considered as much as possible but, ultimately, it will depend on your needs at the time. If you or your loved one have been diagnosed with dementia, some decisions may need to be made well in advance to ensure that your wishes are carried out.
In our homes we have years of experience in caring for people at the end of their life and providing the emotional support needed by their loved ones at such a difficult time. Our residents become part of our extended family, too, so we understand and share in the strong emotions when they die.
Palliative, or end-of-life care, is a special part of our role and our dedicated care and nursing teams create a safe, relaxed environment where the needs of the terminally ill and their families come first. Because of the close relationships that staff develop with residents – and their families – you can be confident that even if no family members can be there at time of death, a resident’s last moments will be filled with compassion, kindness and dignity.
Because our focus is firmly on ‘comfort care’, your room will be kept as peaceful and relaxed as possible. You will be surrounded by familiar possessions, and your family and friends will be able to remain close to you for as much or as little time as you wish. Nutrition is particularly important at this time, particularly when changes in taste, smell and appetite may be affected. We work hard to ensure that you continue to enjoy nourishing food and drinks, especially ones that you particularly enjoy, offering modified textures if you experience swallowing issues.
As part of each resident’s personal care plan, we discuss with their families (and, where possible, with the resident themselves) what their wishes are in the approach to, and immediately after, they pass away. This might include religious or cultural preferences, or anything significant to them.
Our staff receive specialist training in palliative care and are extremely experienced, enabling them to provide the extra level of nursing care that people who are approaching the end of their life need. Close relationships with local GP surgeries and hospitals ensure that additional medical support is never far away.
Some of our home are accredited by, or are working towards, the Gold Standards Framework which is dedicated to improving the quality of care for anyone nearing the end of their life. It aims to ensure that people’s wishes are met, wherever possible, enabling them to live and die where and how they choose. The charity also provides specialist, leading-edge training for staff who care for people nearing the end of their life. Cedars Care Home, in Southend-on-Sea, for example, and its staff have regularly won prestigious industry awards over the last few years in recognition of its high standard of personalised end-of-life care. As an organisation we seek to embody the National Gold Standard in everything we do. For us it’s a whole home approach and we all have our part to play.
Losing a loved one is always hard. We often talk to families about their feelings of loss, combined with guilt that they feel relieved that their relative is now at peace. We understand, and our caring staff are here for the families as well as for our residents.
In fact, we often feel the same way. We become very close to our residents and treat them as our own family members. Even if someone hasn’t lived with us for very long, their nursing, care and activities teams spend a lot of time with them, forging a personal bond. When a resident passes, as well as dealing with it in our professional capacities, we grieve for them, too. We miss them, but we appreciate the privilege of being the people to care for them in their last days.
Planning for end-of-life care involves talking about your needs and wishes with your family, friends and any professionals such as a GP or social worker. It can also involve getting help with practicalities such as financing your care, putting in place a Power of Attorney or making a will.
Making important decisions beforehand means that you do not have to worry about the practicalities if and when you are ill, and avoids the need for family and friends making rushed decisions amidst the throes of grief.
You may need to decide on some complex arrangements about your care and treatments in advance so that you can be sure that your wishes will be carried out when the time comes. These include Advance Statements and Decisions (also called a living will) and a Do Not Resuscitate (DNAR) decision.
Unless you or your relative are currently being looked after in a care home or already have a care plan you will need to have a care needs assessment from your local authority to identify what type of help and support would best suit you. You will also have to undergo a financial assessment to determine who pays for care and you may also qualify for Funded Nursing Care.
Before you move into our homes we will do our own assessment to help us to understand all your needs and ensure that we can meet these fully. We talk to residents and relatives when they first arrive so that we know their preferences for end-of-life care well in advance.
This is called a pre-admission assessment and is carried out by our home managers or a senior member of the team, either by telephone or usually in the comfort of your own home, with yourself or someone who knows your care needs well. We use this information to create a care plan that is tailored to your individual requirements. We will develop this with you, and by talking to your family, so that we can get to know you as much as possible before you move in.
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