3 End-of-life care
End-of-life care is an important part of palliative care for people who are nearing the end of their life. It is for people who are considered to be in the last year of life, while acknowledging that this timeframe can be difficult to predict. End-of-life care aims to:
- help people live as well as possible and to die with dignity
- offer additional support such as help with legal matters
- continue care for as long as it is needed.
From what you have studied so far in this section you will know that holism and person-centred end-of-life care rely on understanding the dying person and their disease or illness. This depends on a good and detailed assessment that takes into account the person’s wishes. In short, it helps lead to a good death.
Having a good death involves paying close attention to what matters to the person who is dying.
In the next activity you watch a video produced by the Social Care Institute for Excellence (SCIE) in which you follow the stories of two women who are approaching the end of their lives. The video follows specialists from a hospice who carry out holistic assessments and support the development of end-of-life care plans based on the wishes of the cared-for person.
Watch the video End-of-life care: what matters to the person who’s dying [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] .
As you watched the video, did you spot how the cared-for persons are included in the decisions about their end-of-life care?
Make brief notes about the plans they made.
You might have noticed that the intervention by the specialist helped provide some clarity for the family of the first patient. The second patient was initially reluctant to make plans about her end-of-life care but, with the help of a social worker, she did make plans for her end-of-life care and felt more confident and in control because she felt supported.
The video emphasises that while we will all die one day, we also only get one chance to get end-of-life care right. It is therefore important to listen and to act on what the person says. This might include explaining what is happening to family members and others who are close to the person. In this way, talking about what a good death can mean to the person can enhance the quality of their life as they near death.
The palliative care specialists from the hospice were very confident in the way they interacted with the two women in the video. This confidence was due to them being very able to do their jobs in difficult situations, but was also down to their understanding that end-of-life care was primarily about the cared-for people. The development of their relationships with the women was built on a particular approach to their role: being person-centred and holistic. This approach was underpinned by principles that guided how they interacted with the two women. These principles are explained in more detail next.