Supporting dignity in end of life care

12 February 2019

End of life care

As the requirement for end of life care approaches, there can often be some difficult conversations to have with the individual and their family regarding their wishes regarding what happens before and after their death.

While these conversations are understandably difficult to have for all concerned, it is very important to be able to grant the wishes of the individual. Meaningful discussions will involve talking about funeral plans, financial distribution to next of kin(s) and a variety of other issues. Having these discussions as soon as possible when an individual enters the care home is important for a variety of reasons.

Arguably, one of the most important reasons is that the persons health might decline rapidly, and they may not be able to express their wishes if they aren’t discussed early enough. Failure to understand the individual’s preferences may also leave family and friends with difficult decisions after their death with no definitive direction of what they might have preferred.

When it comes to the demands on the care staff, staff may feel that they have failed in regard to the person’s duty of care and feel ‘burned out’ from being exposed to such difficult situations. 

The ethics of asking the right questions in an impartial manner is an area which is supported through collaborative working between a multi-disciplined team. The team should ensure that end of life conversations are not overlooked following the care home admission and they will need to focus on the dying person’s wishes to enhance the outcomes for the individual. 

The end of life discussions can positively impact the way staff support the individual at the end of their life and some of the key, critical details about their care are not left to chance. It is a privilege to support the individual to achieve the goals that they have set themselves, until the end of their life.  

As part of this, the understanding of their requirement for independence in some areas, however small, and the recognition of them as a person rather than their illness. One way in which Exemplar Health Care staff have endeavoured to provide an opportunity for residents to enjoy life in a recognisable yet safe way is via food.

Catering Manager at Willowbeck Care Home, Claire Fretwell, has developed the home’s pureed food offering by presenting it in a manner which makes it look like the food it tastes like. Using moulds, piping bags and blenders, Claire and her team work to re-create the food in their original presentation to make it look as realistic as possible.

Food often triggers reassuring memories for residents and by working together with them, their care teams and the wider business, Claire has been able to produce food that they not only want to eat but also food than meets their care plans and dietary needs.

Claire said: “If I can help the people enjoy their food and evoke memories that reassure them, I’ve done my job. We always try to make anything that’s requested as we want to ensure that everyone is enjoying meal times and getting all the nutrition they need.”

The presentation and preparation of food is just one area in which care home staff can consider the ways in which they enrich the final months of an individual’s life while they are in their care.