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End of Life Care Raising an awareness….

End of Life Care Raising an awareness…. ‘an introductory workshop for people who work in settings where EoLC is provided’. Introduction & Housekeeping. Programme. Welcome Learning objectives & ground rules Individual Introductions Introduction to End of Life and Palliative Care

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End of Life Care Raising an awareness….

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  1. End of Life Care Raising an awareness…. ‘an introductory workshop for people who work in settings where EoLC is provided’

  2. Introduction &Housekeeping

  3. Programme • Welcome • Learning objectives & ground rules • Individual Introductions • Introduction to End of Life and Palliative Care • Thinking about who we support and staff involved • Your role in end of life care • Coffee • Case Study ‘Joyce's story’ • Questions and evaluation Lunch at 12.30 – 30 mins

  4. By end of this morning, you will be able to: Explain what Palliative Care & End of Life Care means and the key principles of these approaches. Understand who is involved in EoLC. Understand & discuss how EoLC links to your role. Apply an End of Life Care approach to a patient’s story. Reflect on your learning and identify further training needs Learning Objectives

  5. Ground Rules Confidentiality Shared learning One at a time Respect one another’s opinions Positive critique Sensitivity Time-out Mobile phones/pagers off please Any more?........

  6. Getting to know you…. • Introduce yourself, your role & where you work. • What you hope to get out of the session • Work in pairs

  7. ‘End of Life Care’What does this mean to you?There are no wrong answers!

  8. What sort of illness & conditions might EoLC cover?

  9. Where might you find people needing EoLC? Think outside the box!

  10. End of Life Care Key tools & documentation What are you aware of?

  11. Promotes high quality care across the country for all adults approaching the end of life. Each year around 500,000 people die in England. Some people receive excellent care at the end of life, many do not. Most people would prefer to die at home. In practice, only a minority manage to do so. Services are not always joined up and as a result communication between staff and agencies can break down. End of Life Care Strategy (DoH 2008)

  12. End of Life Care Care that helps all those with advanced, progressive, incurable illness to live as well as possible until they die. Draws attention to the needs of patients and their families, in the last 6 months to year or so of life. It enables the supportive and palliative care needs of both patient and family to be identified and met through out the last phase of life and into bereavement. Includes the management of pain and other symptoms and provision of psychological, social, spiritual and practical support’. National Palliative Care Programme 2006

  13. Gold Standards Framework – Prognostic Indicators Provides guidance to enable better identification patients who may need supportive/ palliative care Highlights triggers for supportive/palliative care including: The ‘Surprise’ Question ‘Would you be surprised if this patient were to die in the next 6-12 months?’

  14. So is End Of Life Care different to Palliative Care?

  15. Palliative Care • ‘An approach that improves quality of life of patients and their families facing the problems associated with life-threatening illness, through prevention and relief of suffering by means of early identification and impeccable assessment of pain and other problems, physical, psychological and spiritual’ WHO-2008

  16. Coffee Break

  17. We all have a role to play!

  18. What concerns do you have in the part you play in providing End of Life Care?

  19. Remember… • It’s OK to have concerns, most people do • It’s OK not to know the answer but remember the question and pass it on! • It’s not OK to ignore the concern either yours or client/family

  20. Joyce, age 81, is a widow who lives alone in a 2nd floor flat. Has Advanced Lung Disease In the past 3 years she has only left her flat to go into hospital (4 times) Only family is a grandson & his family who live close by Has told her grandson that she knows that the doctors are unable to do any more to help her. ‘Wants it all over now’ Now stays in bed most of the time, has no appetite and finds difficulty in taking all her tablets. Has made it clear that she would like to die at home in her own bed. Introducing Joyce….

  21. If Youwere in this position, what would you expect from staff looking after you ? (helpful to think about Knowledge, Skills and attitudes)

  22. Holistic approach to care

  23. Supporting Joyce… • Small group work

  24. What do you think may help Joyce remain at home?

  25. What might help Joyce remain at home … • Making her wishes known to her family and professionals – • Advanced Care Plan • Discussion of preferred place of death with healthcare • professionals. • Ensure that Joyce is included on the Gold Standards Framework • (GSF) register at her GP practice (Thomas,2005). • Healthcare professionals have an agreed plan of how to manage her • worsening breathlessness • Increased care package including Carers Allowance & Continuing • Health Care funding • Involvement of specialist palliative care nurses • Hospice at Home • Having a written statement of her wishes such as an ‘Advanced • Decision to Refuse Treatment’

  26. Bereavement Care Joyce dies peacefully with her family near a few days later. What may help the family at this time?

  27. Acknowledgement of what’s happened • Empathy & honest communication • Written & practical information • Contact details of who can help now and later

  28. One thing that you will take away from this morning that may change your practice Reflective Learning

  29. Where next? • Further training within the county http://www.gloucestershireccg.nhs.uk/?page_id=176 • Calendar of events (via website above) • E learning www.e-elca • Shadowing other staff • Personal reflection

  30. Summary & Evaluation • Final Questions? • Revisit objectives and hopes • Evaluation • Handouts • Certificate of attendance

  31. References Department of Health 2008. Advanced Decisions to Refuse Treatment The National Council for Palliative Care Department of Health 2008. End Of Life Care Strategy. London: Crown Publications NHS 2008 National End of Life Care Programme. Advanced Care Planning. University of Nottingham The Gold Standards Framework; the Liverpool Care Pathway; the Preferred Priorities for Care tool: see www.endoflifecareforadults.nhs.uk WHO 2008. WHO Definition of Palliative Care Available at: www.who.int/cancer/palliative/definition/en

  32. Lunchtime- please be back for 1pm

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