A focus on enabling people to die in their preferred environment is allowing more freedom of choice for patients to have a say in their care in those final stages of life.
Approximately 74% of people express the want to spend their final stages of life at home.
A focus on enabling people to die in their preferred environment is allowing more freedom of choice for people to have a say in their care in those final stages of life. Many people have strong wishes, not to be admitted to a hospital or hospice for many reasons, including being somewhere that brings them comfort with people around them to support them in their final moments. It also gives them more confidence that their wishes will be adhered to and have more control over their care. More people are making the choice to arrange homecare and is expected to continue to rise.
High-quality end-of-life care is important to ensure people that are approaching the end of their life, their families, and carers, have access to the right level of care during a very vulnerable time in their lives, which raises the question about whether the right staff with the right skills to support people in their own homes are prepared for the increasing level of demand. Personalised care to the preferences of the individual, with the correct support in place allows people to plan for those eventualities with confidence and comfort that their wishes will be carried out.
Home care services offer customisable support options that allow individuals to receive care in their own homes. This includes personalised care, flexibility in scheduling, and the emotional comfort of staying in a familiar environment while meeting diverse care needs.
Often the topic of planning for end of life is overlooked and not discussed with people, whether that be due to the topic being uncomfortable or the fear that it will bring fear. Yet it is something which affects us all which raises the subject of why people are not exploring end-of-life care, what makes a good death and what needs to happen to ensure that everyone has access to the care and support they need as they approach the end of their lives. Not discussing this at the appropriate time to plan can bring many problems later down the line when people may lose the capacity to make those decisions, leading to questions about the extent to which people are able to make meaningful choices in their final weeks and months of their life to ensure people are in ‘good’ places to die.
On average in the last 3 months of life, 64% of people will have at least one emergency admission into the hospital, which can often determine their place of death if no plans are discussed and arranged prior to a decline in their health. The complex nature of end-of-life care can be challenging, often requiring the skills of various professionals and domiciliary care workers to be involved in the provision of care. Often people are admitted to hospital and then await a place in a hospice, where places are scarce. This often means that whilst waiting for that place the patient passes away whilst still in a hospital setting.
This highlights the importance of greater communication between home care agencies, GPs, Hospital discharge teams, community nursing teams and families, to ensure specialist care in the community is available at the right times to those who wish to die at home.
In addition to having end-of-life care in a more comfortable, familiar environment for the patient, it can often mean more practical and emotional support for carers and families supporting their loved ones allowing more involvement in their care.
Studies have found older adults who died at home were more satisfied with their end-of-life care than those who were in a hospital setting. This includes the ability to be surrounded by family in the familiar environment of their home rather than a more sterile environment, like a hospital, that lacks privacy and comfort. Aside from the emotional benefit, people who receive home care are less likely to experience emergency admissions to hospital, resulting in lower costs to the healthcare system.
It is clear from research conducted, that preferences and feelings around end-of-life care can have a significant impact on the quality of people’s final weeks and months of their life and facilitate greater well-being. Employing a home care provider can enhance independent living, allowing individuals to manage everyday tasks effectively while receiving the necessary support.
End-of-life care is a compassionate and holistic approach designed to provide comfort, support, and relief to individuals nearing the end of their life. This type of care addresses not only the physical needs but also the emotional, social, and spiritual aspects of the individual and their loved ones. It can be provided in various settings, including at home, in hospitals, or in hospices, depending on the preferences and needs of the individual.
The primary goal of end-of-life care is to enhance the quality of life for both the individual and their family, rather than focusing on curing the underlying illness. This care involves a dedicated team of healthcare professionals, such as doctors, nurses, social workers, and spiritual care providers, who collaborate to offer comprehensive support.
End-of-life care encompasses a wide range of services, including pain and symptom management, emotional and spiritual support, and practical assistance with daily tasks. Additionally, it involves advance care planning, which empowers individuals to make informed decisions about their care and treatment preferences, ensuring their wishes are respected and followed.
Many people will discuss end-of-life issues with their GP, often about subjects such as DNACPR (AKA do not resuscitate). A correct assessment is crucial in end-of-life care to improve the quality of life for patients facing life-threatening illnesses. However, discussions about end-of-life need to go much further than this to address the abundance of varying factors and concerns shared by people reaching the end of life and their families: understanding prognosis, fears about dying, end-of-life goals and wishes and how their physical and mental needs can be met in the environment of choice. The facilitation of a comprehensive treatment plan reflecting a person’s wishes can often be achieved in a simple 4 step approach with the person and their family/carer; (1) Initiate the discussion – this is often best had in a familiar, comfortable setting where there is least disruption and clear decision-making can be made at a suitable time. (2) Clarifying prognosis – ensuring the patient and the family are aware of any diagnosis and the implications this may have on their wishes or what level of care may be needed to ensure they can remain in their chosen environment. (3) Discuss and decide on end-of-life goals/wishes – facilitate open discussion on desired medical care and any remaining life goals. Treatment wishes – for instance, pain medication, avoiding hospitalisation or any unnecessary procedures. (4) Developing the plan – sharing amongst all professionals involved to ensure everyone involved in that person’s care is aware of their wishes. Involving family and other professionals/carers in these discussions can strengthen support and reduce isolation for the person in question.
Ensuring these plans are documented and shared can reduce the possibility of instances of conflict if family/carers’ thoughts or beliefs do not align with the wishes of the person at end-of-life.
Receiving end-of-life care at home offers numerous benefits for individuals and their loved ones. One of the most significant advantages is the increased comfort and familiarity of being in one’s own home. This familiar environment can provide a sense of peace and security during a challenging time.
Home-based end-of-life care also allows individuals and their families to have greater control and autonomy over their care and treatment preferences. This can lead to an improved quality of life, as individuals can maintain their independence and dignity even in the face of a serious illness.
Moreover, receiving care at home can reduce stress and anxiety for both the individual and their family members. The home setting eliminates the need to navigate a hospital or other healthcare facility, which can be overwhelming and stressful. Instead, individuals can receive personalized care in the comfort of their own home.
Additionally, home-based care provides increased support for family members, who often play a crucial role in caring for their loved one. This support can include emotional and practical assistance, helping family members to cope with the demands of caregiving and ensuring they are not alone in this journey.
Home Instead Cleveland provides the highest quality end-of-life support for people wishing to remain at home in their final stages of life. Helping to facilitate the wishes of that person whilst consistently advocating for them to ensure their needs and desires are met. The benefits of having an own carer include dedicated, one-on-one support tailored to specific needs, enhancing the overall experience and satisfaction of receiving assistance in the comfort of one’s home. Often our Care Professionals become a source of strength and comfort for people experiencing end-of-life, reducing isolation, and ensuring the highest quality of homecare is received.
The primary role of a palliative care team is to relieve suffering and improve the quality of life for individuals facing serious illnesses. They work closely with the individual and their family to develop a personalised care plan that addresses their physical, emotional, social, and spiritual needs. Their goal is to offer compassionate and comprehensive care that enhances the quality of life for individuals with serious illnesses and supports their loved ones throughout the care journey.
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