Wednesday, 12 December 2012

End of Life Choices

According to The Guardian, ‘research shows that 70% of adults would like to be cared for and die in their own home. But great majority of us still die in hospital; today, two out of 10 are able to fulfil this final wish. .

 It may still be a lottery postcode as to whether we get the support we need to stay at home at the end of our lives,  but we do have some control over the kind of treatment we receive – or to be more precise - choose not to receive.
Euthanasia and assisted suicide  are against the law, but thanks to the Mental Capacity Act of 2007 we can chose to write a Living Will.  A Living Will (also known as an Advance Directive ) allows us to state what treatment we want to refuse even if refusing it will bring about  the end of our lives.
 it is legally binding and providing it is relevant to your circumstances at the time it cannot be overturned.
 It is important to think in advance about the decisions you would like to make if you do not have the 'capacity' at that time to do so. Would you want  to be kept alive artificially, or have every effort made to resuscitate you?
 We can make our end of life choices in two different ways:
 We can either  appoint someone to have our Lasting Power of Attorney allowing them to make decisions about our end of life treatment when we are no longer able to.  Alternatively as stated above we can write it down, but its no good putting it with your Will which will only be read after you are no longer alive, it must be accessible, so make sure your GP and family have a copy.
You may not be able chose where you spend your last days - but at  least you may have some control over how.




Sunday, 9 December 2012

Buzz words don't lead to better care

’Nurses who fail to demonstrate compassionate care are betraying the values of their profession’, according to the Chief Nursing Officer for England’
Compassionate is not a verb. You can’t order a nurse to be compassionate. Compassion is a reaction to seeing someone who is vulnerable, suffering, unable to help themselves. A compassionate response would be a desire to help them.
But no directive is going to make that happen.
In 2001 we had the Department of Health’s  Social Care Institute for Excellence which intended to improve social care in England. The word excellence of course made their results excellent. Not.
 We also had the Dignity in Care campaign launched by the Department of Health in 2006. Well, that worked well!  Now we have The Royal College of Nursing telling the nurses to be compassionate. They think that by using more meaningful words they will deliver more meaningful care.
Every year seems to be another  year of magical thinking.
 According to the Royal College of Nursing Since the coalition came to power in May 2010, the NHS workforce in England has decreased by 28,500 posts, and a further 32,700 jobs are at risk.
The number of qualified nurses working for the health service reduced by more than 6,000.(
There seems to be a belief that it is possible to  ignore  the reduction in  staffing levels, the increase in bed occupancy, and  the looming  explosion of our ageing population heading towards the end of their lives, and that it will be enough to periodically  sprinkle a few flowery adjectives to describe the new model of care, and hey presto the care will improve as if  by magic.
The reality is that the par between the real and the intended care  just gets bigger and bigger, and the Government’s Department of Health and the Royal College of Nursing’s mission statements  look  more and more like a feeble  marriage vow taken moments before the groom runs off with the bridesmaid.