Tag Archives: palliative care

Good practice in palliative care

Note that this post includes end of life details which you may want to avoid.

The Assisted Dying Bill has raised questions about the quality of palliative care under the NHS. Whatever your views on assisted dying it should never be a substitute for good care at end of life.

Recently I and my family have had a positive experience of palliative care in an NHS hospital, and I am wondering how widespread this is.

My husband, Ian, died last month in Kingston Hospital. It was not unexpected – he had spent almost half of this year in hospital, six visits in total. During the year he was transferred to the Elderly Care (aka Geriatric) team, who took a refreshingly holistic approach to his multiple health conditions. However each time he was admitted his health and mobility dropped down a notch, so he eventually he became effectively bed bound.

Just before he was admitted for the last time he told me that he had had enough and it was time to go. From his hospital bed he made last minute changes to his funeral plans which he had drawn up under Covid. In fact he rather surprised some visitors by discussing it in some detail, asking them to contribute in some way.

Eventually it became clear that the treatment was no longer effective. Our sons were staying with me by that stage, and I asked if one of us could stay all night. They moved Ian into a single room so we could come and go as we pleased.

Posted in Op-eds | Also tagged and | 10 Comments

Assisted Dying and Palliative Care; it isn’t a choice, we need both.

With Kim Leadbeater’s Private Members Bill on Assisted Dying comes up for its Second Reading at the end of next month, now is a good time for us to be talking about the issues involved and why it should never be a choice for those facing a diagnosis of a fatal illness between giving them a choice when and how they die if they wish or providing them the best quality palliative care to allow them to live as long as possible. Both are needed and the debate about the bill must not be about choosing between the two.

Much is spoken about how palliative care can and does help those with a terminal illness deal with physical pain during their illness. In hospitals, in hospices and at home, helping those facing death live their life as fully as possible. Such care also helps those close to the patient by sharing the support needed, both physical & psychologically.

Posted in Op-eds | Also tagged | 22 Comments

Action needed in Scotland to help terminally ill homeless people

Last week, Ed Davey introduced a Bill which, if it passes, would ensure that terminally ill people who are homeless are given the housing and end of life care to ensure that they die with as much dignity and comfort as possible.

Ed’s bill only applies to England. I thought I would have a look at what happens in Scotland. I’d thought that things would be much better north of the border, but they aren’t.

A Marie Curie Scotland briefing to the Scottish Parliament’s Local Government Committee’s inquiry into homelessness makes me very worried:

It is clear that that providing both specialist and general palliative care for homeless people is complicated and challenging and at present not every homeless person living with a terminal illness is getting the care they need.

The Scottish Government needs to ensure that research is done urgently so that appropriate action can be taken to fill the gaps in care.

The Marie Curie briefing outlines where the problems lie. It is not easy for homeless people to access palliative care:

Access to hospices and care homes is very rare for homeless people living with a terminal illness. A lack of any fixed abode makes it difficult, if not impossible for community palliative care teams to meet the needs of homeless people. The only possibility may be through a hostel, a setting in which can be very difficult to deliver care and not necessarily set up for end of life and palliative care. Many staff in hostels will not have the training and support they need to support someone at the end of life, despite in many reported instances of going ‘above and beyond’ in their roles. Education and support in line with the NHS Education for Scotland and Scottish Social Services Council Palliative and End of Life Care framework should be made available to hostel staff.

They recommend a “housing first” approach:

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