Other Articles of Interest

Here are other interesting articles which pertain to various aspects surrounding the end of life.

Supporting people to live and die well: a framework for social care at the end of life: In July 2008 the End of Life Care Strategy for England and Wales was published, launching a comprehensive programme to transform the care given to people apporaching the end of life, their families and their carers. The National End of Life Care Programme can point to many successes already in changing the culture of dying, and improving the services provided and skills and training of the workforce. Simutaneaously, social care is undergoing a transformation. The vision set out in 'Putting People Firsr' is for services to work around the people who use them, the social care workforce having at its heart a commitment to work in partnership with service users and their carers, supporting the choices they have made for their care.
Variations in Place of Death in England: This report, the first in a series commissioned by the NEoLCIN and written by the South West Public Health Observatory, will be very useful to commissioners and providers of end of life care, researchers and academics, and a wide range of practitioners and policy makers across the health and social care and public and private sectors. It highlights some fascinating variations in where people die and challenges current thinking about the appropriateness of different end of life care settings for different groups, depending on their age, sex and socioeconomic status. It demonstrates the complex interplay of these factors in determining end of life experiences. As such, reading this report should be a high priority for anyone working in the field.
The integrated implementation of two end-of-life care tools in nursing care homes in the UK: an in-d: Abstract; In economically developed countries there is a rapidly increasing number of older people living and dying in care homes. The relative isolation of nursing care homes from the development of palliative care, the poor retention and recruitment of staff, and the lack of medical cover, hinder the provision of quality end-of-life care. End-of-life care strategies internationally highlight the benefit of using tools to help improve end-of-life care in care homes. All seven private nursing care homes within one district in Scotland undertook to implement, as a package, two end-of-life care tools, namely, the Gold Standards Framework for Care Homes (GSFCH) and an adapted Liverpool Care Pathway for Care Homes (LCP). A model of high facilitation, visiting the homes every 10–14 days with significant in-house staff training, was used to implement the 18-month programme. The notes of 228 residents who had died prior to and during the project were examined, alongside a staff audit looking at the effect that the project had on practice. A nurse researcher undertook qualitative interviews of bereaved relatives, pre-/post-implementation. This paper reports the results of an in-depth evaluation of professional practices and residents outcomes. There was a highly statistically significant increase in use of Do Not Attempt Resuscitation (DNAR) documentation, advance care planning and use of the LCP. An apparent reduction in unnecessary hospital admissions and a reduction in hospital deaths from 15% deaths pre-study to 8% deaths post-study were also found. Further work is needed to assess the optimum input required for successful implementation.
Irish Views on Death and Dying: A National Survey: The Journal of Medical Ethics recently published an article on "Irish views on death and dying: a national survey". Lead researcher was Dr. Joan McCarthy of the School of Nursing and Midwifery,University College of Cork. The study was financed by the Irish Hospice Foundation.
Two Part Series for GP's on Bereavement Care: Susan Delaney, Bereavement Services Manager with the Irish Hospice Foundation, presents a model of how different people respond to bereavement and how GPs might respond to the needs of bereaved patients.
Letting Go-What should medicine do when it can't save your life? by Atul Gawande: Modern medicine is good at staving off death with aggressive interventions—and bad at knowing when to focus, instead, on improving the days that terminal patients have left.