1. End Of Life Care
Ruth Kyne

2. Palliative Care
Palliative Care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. (WHO 2002)
2/23/2019 5:06:01 AM

3. The Surprise Question

4. End of Life
Patients are ‘approaching the end of life’ when they are likely to die within the next 12 months.
This includes those who have advanced, progressive incurable conditions; those with general frailty and co-existing conditions
Those at risk of dying from a sudden acute crisis in an existing condition; and those with life-threatening acute conditions caused by sudden catastrophic events.
2/23/2019 5:06:01 AM

5. Last Days of life
Those patients whose death is expected within hours or days
Commence the Shared Care Record
2/23/2019 5:06:01 AM

6. 2/23/2019 5:06:01 AM

7. Gloucestershire Clinical Programme Board Strategy 2017
Education Framework
Plans for a link worker role across the county
2/23/2019 5:06:01 AM

8. 2gether Trust EOLC Steering Group Introduced bespoke EOLC training
Introduction of syringe drivers and supporting policy
Developed Care of the Dying Policy
Action plan that reflects the Ambitions for Palliative and EOLC
Developed the role of Link Workers
2/23/2019 5:06:01 AM

9. Continued Respect /DNAR
Enhanced environment for EOLC ie. Sensory room and the relatives room
Johns campaign
EOLC reviews
Advanced Care Directives
Part of a research programme
2/23/2019 5:06:01 AM

10. Developments within the ward environment:
The Ceiling of Care/ Patient Treatment Options discussions take place early in admission
The use of syringe drivers if appropriate to the clinical presentation i.e. pain relief/breakthrough pain etc.
Staff confidence has grown in relation to working with both the patient and their carer.
With the help of the Allied Health professionals we create a less clinical room, scent blankets, chairs etc.
The hospital has a relative’s room suite.
We provide food, drinks and company to relatives.

11. Developments continued:
With the help of the Allied Health Professionals we have created a less clinical room, scent, blankets, chairs, soft lighting etc.
The hospital has a relative’s room/suite.
We provide food, drinks and company to relatives
Staff are proud of what they do.
“ Its a privilege to look after someone during their last few days and hours” – Staff member

12. # hello my name is …..
2/23/2019 5:06:01 AM

13. What Next?
We have been promised help in the form of resource and manpower to transform one of our bedrooms into an less clinical end of life room. Courtesy of the Cobalt Unit and volunteers from IRESS.
Staff are enrolled on the End of Life Development Plan, provided within One Gloucestershire.
Further masterclass and development training
Embed learning from reviews into practice using SBAR

14. What Next Continued … Promote Dying Matters week
Ensure that all the projects undertaken by staff on the Development course are supported
Publish the work done to date
Collaborative working with new partnerships
Include EOLC on induction
2/23/2019 5:06:01 AM

15. Some of the feedback received:
“We wouldn’t have received better care if we paid privately for it”
“Thank you all so much for the care you gave my dad and the love you showed him as you cared for him”
“I know my step mother found it comforting during her long hours there she was able to hold his hand as he passed away”
“Thank you for the loan of a comfortable chair!”

16. More feedback:
“You all touched our lives in some way by looking after our lovely mum. We felt great comfort that she was being so well cared for and loved by you all”
“At the funeral yesterday everyone commented to me on the superb level of care received from the staff”.
“Thank you for allowing me to care for mum after her passing, those memories will last forever”.

17. Knowledge/Skills needed
Awareness of what end of life care is and when it occurs
Holistic Care: Physical, Psychological, Social and Spiritual
Communicating with patients and those important to them
Advance Care Planning skills
2/23/2019 5:06:01 AM

18. Competencies, underpinning knowledge and values needed
Communication skills
Assessment and care planning
Advance Care Planning
Symptom management
Maintaining comfort and wellbeing
Occupation specific requirements
2/23/2019 5:06:01 AM

19. Physiotherapy, Occupational Therapy, Psychological Therapy, S<
Specialist Clinics, Specialist Doctors, District Nurses, GP, Community/IP Nurses, Consultant(s)
Funeral Directors, Solicitors
Relatives, Friends, Work Colleagues, Care Home, Nursing Home, Neighbours
Palliative Care Team, Hospice at Home, Hospice’s Ambulance
2/23/2019 5:06:01 AM

20. The Bereaved and Family

21. One Chance To Get it Right
2/23/2019 5:06:01 AM