There are two impressions you'll never ever be able to repeat
that's the first impression when somebody meets you for the first time
and at end of life
when somebody leaves the home
that impression will always stay with the family.
We have our first end of life discussion
very soon after admission which sounds very cruel
but it's a very good discussion to have early on because emotions aren't
as high as they are at the end.
So one of the first things we ask is
have you thought about an undertaker which again it's a very sensitive thing to talk about
and have you thought about cremation or burial
and that's the important things to find out because - and I explain this to families to say
we need to know so that at the time things happen and your emotions are very high
we can take that away from you and deal with it.
Thinking about death is really hard
but it's a fact of life for people living in care homes and for
people working in care homes and the families of people who live in care homes.
And taking a proactive approach to help people think about how they want their
end-of-life to be, who they want involved in planning what they want to happen,
celebrating their life after they've passed and supporting both the staff and
their friends who were living around them to come to terms with that grief
it's something that care homes need to look at and find ways to engage with.
There can be staff who are familiar with death and there can be some staff who
still find it upsetting perhaps even after many years
particularly if they are
residents that they've got to know and love as as part of their family so to speak.
To be able to use this tool to maybe sit down and see how they can make
things better not just for the resident and the family perhaps also for the
staff as well I think this tool would be really important.
You can't undertake end-of-life care if you're not prepared to do that as a team
that initially that has to be a team discussion about how they feel,
what their fears and fantasies are
because that's ultimately going to impact on
whether you're going to be able to deliver that, because if someone is in
final days and final hours you're not going to know that it's going to happen
on a Tuesday at 12 o'clock it could happen at any time
and so - and anyone could walk into a room and
find someone in distress.
So everyone has got to be on board and everyone has got
to be included and feel included in that process.
Really I've never come across
anyone who has wanted to talk about end-of-life care
and the only way that you can progress that discussion is by having a
connection and the trust of the individual and perhaps developing that
information over time.
And knowing for that person
when it starts to raise anxiety for them
and you just stop the conversation and perhaps come at it
at a different angle.
What I've usually found is
people are much more aware than you think they are
people usually think or know more than than you think they will.
So although you still talk about things very sensitively I think you
start the conversation and see where where they want it to go.
Everyone is entitled to having a good death
so that's pain free it's comfortable it's individual.
It's on their terms.
One of the residents actually passed away here.
We were very close.
Obviously you know you sort of talked about boundaries and things
but at the end of the day you formed a relationship with an individual
and they saw you as part of their family
and I think if somebody wishes to be
they have spent their last hours in the home with you with them
if you're able to do that then that makes them feel at ease and it makes you feel that you're
doing the right thing by that person.
I think as well having somebody that they
can trust and somebody that they feel
a warmth with and for
having in person
that person there towards your end of life is a very rewarding thing.