Supporting Good End of Life
We value the ‘living’ and ‘dying’ in care homes and helping each other prepare for a ‘good death’.
Care homes are places where people live and where many will ultimately die. Many homes have excellent skills in supporting end of life. In society, there is a real taboo about talking about dying and death, but it is important to have opportunities for discussion around this subject at a time conducive to older people.
‘Death is such a taboo subject. It’s a big problem because all of us are so near to death. By 90 you can’t get much nearer without knowing that it is around the corner, and we need to be able to express that sometimes if we want.’
Care homes are complex systems where people are both living and dying. Many are also experiencing multiple losses. There is a need to develop a culture of relationship-centred care, with the emphasis on personal need and dignity, through which older people, their relatives and staff are supported. Encouraging an open approach to the awareness of dying is a key cultural shift – not just in care homes but in society.
Creating end of life care requires thinking about issues such as:
- It can be difficult to predict when someone will die, so promoting good end-of-life care should be integral to quality care in care homes. Practices and interventions rooted in palliative care, and support from specialist palliative services, are helpful.
- Existing standards, frameworks and tools can help support good palliative care.
- It is important that staff, family and other people living in the home receive continuing support following a death.
- Opportunities for everyone touched by an older person passing to discuss their feelings and to ‘say goodbye’ can occur at the funeral or memorial service or through remembrance events.