As human beings, we often find ourselves immersed in the hustle and bustle of everyday life, rarely taking a moment to contemplate the inevitable end of our journey. However, amidst the chaos, there lies a crucial aspect of life that deserves attention and careful consideration – end-of-life care planning.
In the realm of caregiving at the Future Care Group, every day is filled with compassion, empathy, and understanding. As carers, we’ve had the privilege of witnessing the profound impact of end-of-life care planning on residents and their families. In this article, we delve into the significance of planning for end-of-life and the benefits it offers to everyone involved. We also share some of our experiences and reflections on the importance of embracing end-of-life care planning, particularly within the context of a care home.
End-of-life care planning encompasses a range of decisions and preparations made to ensure comfort, dignity, and autonomy during the final stages of life. It involves creating advance directives, appointing healthcare proxies, and discussing preferences regarding medical treatments and interventions. Despite its sensitive nature, engaging in end-of-life care planning provides individuals with a sense of control over their destiny and allows them to make informed choices that align with their values and wishes.
It is important to highlight that when we talk about end-of-life care, we are referring to the last few weeks of a person’s life. It is common for individuals to confuse this type of care with palliative care, when in fact, there are several key differences between palliative and end-of-life care. The main one being that palliative care is not limited to end-of-life situations and can be provided at any stage of an illness, often alongside curative treatment.
Across our eighteen care homes, we incorporate our LIFE strategy into both end of life and palliative care planning to ensure every resident’s needs and wishes are met in the way they request:
We listen to residents, staff, relatives, and other healthcare professionals, sharing ideas of how we can develop our approach to end-of-life care and acting on the feedback we receive to help our residents continue to live a meaningful life up until the end.
We communicate with all our residents and understand the importance of involving them in daily life wherever possible. We also facilitate socialising with other residents and arrange activities to keep the mind and body active.
We make sure that our residents enjoy as much freedom and independence as possible. They can make their own choices and continue to enjoy the interests that have always brought them joy for as long as possible.
We engage with residents and their loved ones so that we can improve their health and wellbeing while in our care. And when the inevitable happens, we will be with our residents and their loved ones every step of the way.
End-of-life care planning should not simply be about the practicalities, for us it is about understanding what our residents want, fulfilling wishes, and providing quality of life before, during and after they have passed.
Advance directives are an essential part of care planning. They are guiding documents that outline an individual’s preferences for medical care in the event that they are unable to communicate their wishes. These directives, including living wills and durable power of attorney for healthcare, offer clarity to healthcare providers and family members. They also help minimise uncertainty and potential conflicts during critical moments. By documenting preferences regarding life-sustaining treatments, palliative care, and end-of-life interventions, individuals ensure that their wishes are respected, relieving their loved ones of the burden of making difficult decisions on their behalf.
End-of-life care planning also encourages open and honest communication among family members and healthcare providers. By initiating conversations about death, dying, and end-of-life preferences, individuals foster understanding and mutual respect within their support networks. These discussions not only strengthen familial bonds but also provide an opportunity for individuals to express their values, beliefs, and concerns, paving the way for a more compassionate and supportive end-of-life experience.
Each of our residents’ journey is marked by a unique tapestry of memories, experiences, and relationships. As carers, we’ve learned that end-of-life care planning is not solely about managing medical needs but also about honouring residents’ autonomy, dignity, and wishes. By engaging residents in conversations about their preferences, values, and fears surrounding the end of life, we create a supportive environment where their voices are heard and respected.
Sue Roberts, Group Head of Quality and Compliance & Senior Risk Manager at the Future Care Group tells us:
“With end-of-life care, we only get one chance to get things right. From the moment residents enter our care, we initiate discussions surrounding palliative and end-of-life care with both them and their loved ones. This early engagement is vital as care needs can evolve swiftly, necessitating adaptable and responsive support. However, beyond logistical considerations, our aim is to uncover residents’ dreams, wishes, and aspirations, often unfulfilled amidst the challenges of illness.
For instance, we have recently cared for a young lady of 56 who was dying of breast cancer. When we were chatting with her, we asked her ‘if anything was possible, what would be one of your wishes?’ She told us that she would love to ride her motorbike again. Though physically unattainable, we refused to let her dream go unfulfilled. With the help of the local Harley Davidson community, we orchestrated a memorable afternoon where she was whisked away in a sidecar, embracing the freedom she cherished. Though she passed away shortly thereafter, she departed with a fulfilled wish and a smile on her face, a testament to the power of compassionate care.
It’s the little things that really make the difference – what does a resident want when they move into that closing down stage? What sort of music do they want in their room? Would they welcome the tranquillity of a Namaste session? Whom do they wish to have by their side in their final moments? Such inquiries, while seemingly small, hold immense significance in ensuring personalised and dignified care.
As caregivers, we meticulously consider all facets – physical, psychological, social, and spiritual – to craft a comprehensive plan tailored to each resident’s wishes. By understanding their desired approach to death, we strive to create an environment where they can find solace and peace. Our commitment is unwavering – we must get it right, honouring their journey with the utmost compassion and respect.”
Planning for the end of life goes beyond documentation. It prioritises the preservation of dignity, comfort, and quality of life during the final stages. By articulating preferences for pain management, hospice or hospital care, and spiritual support, individuals empower themselves to receive care that addresses their physical, emotional, and spiritual needs. Moreover, end-of-life care planning encourages individuals to reflect on their life’s legacy, fostering a sense of closure and peace as they approach the end of their journey.
Roberts adds:
“Ensuring the comfort of individuals in our care is paramount, especially when they may no longer be able to communicate their needs verbally. This is where PainChek®, an innovative AI tool, plays a crucial role across our care homes. PainChek® uses facial recognition technology to assess residents’ pain levels accurately. Even when verbal communication is no longer possible, PainChek® provides valuable insights into the resident’s discomfort, allowing us to respond promptly and effectively.
By regularly incorporating PainChek® into our care provision, we can monitor changes in pain levels and adjust care plans accordingly. However, identifying pain is just the first step. It’s essential that our staff, particularly nurses, are proficient in administering pain relief through techniques like syringe drivers when necessary. This ensures that residents receive the appropriate level of care to alleviate their discomfort and enhance their quality of life.
In addition to pain management, we prioritise the implementation of anticipatory medications as part of our end-of-life care planning. Anticipatory medications are pre-emptively prescribed to address potential symptoms or complications that may arise as residents approach the end of their journey. This proactive approach ensures that residents receive timely and comprehensive support, promoting comfort and dignity during this sensitive time.
By integrating tools like PainChek® into our care practices and ensuring our staff are well-trained in pain management techniques, we can provide compassionate and effective care tailored to the unique needs of each resident. This commitment extends to proactive measures like anticipatory medications, ensuring that residents receive the support they need to navigate their end-of-life journey with comfort and dignity.
Sometimes a simpler proactive method is required. For example, in cases where a person’s condition involves the risk of tumour bleeding into a blood vessel or artery, it’s essential to consider practical measures to maintain their comfort and dignity. This includes ensuring that their wardrobe contains clothing in dark red or dark green hues. Should bleeding occur, these colours help conceal any blood stains, preserving the individual’s sense of privacy and dignity during what can be a distressing time.”
End-of-life care planning not only benefits residents but also provides solace to their loved ones. By clearly communicating their wishes and preferences, residents spare their family members from the anguish of making difficult decisions in times of crisis. By designating healthcare proxies and discussing end-of-life arrangements, individuals alleviate the burden of uncertainty, allowing their loved ones to focus on providing emotional support and companionship during their final days.
By offering emotional support and guidance to families, we ensure that they feel equipped to navigate the challenges of caregiving and bereavement with resilience and compassion.
At the heart of end-of-life care planning lies the essence of human connection – the bonds forged between residents, families, and caregivers. As carers, we’ve witnessed how open and honest conversations about end-of-life preferences foster deeper connections and understanding among residents and their loved ones. By creating a safe space for residents to share their fears, hopes, and dreams, we cultivate a sense of belonging and support that transcends the boundaries of age and illness.
End-of-life care planning honours the individuality and legacy of each resident, celebrating their life’s journey with reverence and respect. From capturing their life stories to facilitating legacy projects and meaningful activities, we ensure that residents’ legacies are preserved and cherished. By embracing their cultural traditions, spiritual beliefs, and personal preferences, we honour the richness and diversity of their experiences, leaving a lasting imprint on generations to come.
As carers in a care home, we’ve come to appreciate the profound importance of embracing end-of-life care planning as a cornerstone of compassionate caregiving. By empowering residents and families, fostering meaningful connections, and honouring individuality and legacy, we create a supportive environment where every resident’s end-of-life journey is embraced with dignity, grace, and compassion. In the realm of caregiving, end-of-life care planning enables us to walk alongside residents and families, offering comfort, solace, and companionship during their final journey.
If you would like to find our more about any of our care services at the Future Care Group, please feel free to contact our friendly team who would be happy to discuss your needs.
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