Hot Topics and Advance Care Planning in a snap shot! Dr Ros Taylor Hospice Director, Hospice of St Francis, Berkhamsted Trustee, Help the Hospices [email protected]07515747440 Sarah Russell Director of Education and Research Hospice of St Francis, Herts and Mount Vernon Cancer Network End of Life Education Project Lead in Care Homes and GP Practices [email protected]or [email protected]1 ‘Are you prepared should one of you melt ?’
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Hot Topics and Advance Care Planning in a snap shot! Dr Ros Taylor Hospice Director, Hospice of St Francis, Berkhamsted Trustee, Help the Hospices...
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Hot Topics and Advance Care Planning in a snap
shot!Dr Ros Taylor
Hospice Director, Hospice of St Francis, Berkhamsted
…..if palliative care introduced early !! N Engl J Med 2010;363:733-42 Temel
Themes
WHERE to die ?
WHEN to die?
HOW we die ??
Place - does it matter ??
?Home
?Hospice
?Hospital
Hospice of St Francis Beds x12 Doctors !
Education
Spring Centre – outpatients
Triage
01442 869550
Work with the Peace, NHS, Iain Rennie Grove House
Canada
• 80% patients want to die at home
• Only 50% of their relatives support this
• Only 5% of these relatives felt they had the skills and knowledge to care
Guberman
Family Care
…..Or is it
Family Scare
OR
Debbie died at home last week…..what made it possible ?
• Mac Nurse diagnosed ‘terminal phase”• Grove House OT …equipment• GP who visited…..DNA CPR in house• St Francis Hospice Doctor advised by phone• Texts and mobile to main carer• Just in Case meds for last hours• Advance care discussions recorded• Informed resilient carer….KEY
A good death in
the bed you die in
Barbara Monroe
CEO St Christophers Hospice
When we die ?
Assisted Suicide
Decision making
Ask the question
Is this patient dying
Should we still be actively treating ??
= DECISION POINT
= Transforming points
How we die ???
TERRORfear
panicdeath anxiety
www.dyingmatters.org
Advance Care Planning
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Health and social care parallel process of anticipating the advance
care planning needs of the patient/client
Advance Care Planning Theoretical ModelRussell 2012 (in press)
Advance Care PlanningThe Activity
The Advance Care PlanAdvance Advance Lasting PowerStatement Decision Attorney
To Refuse (Welfare)Treatment
1. GP End of Life Education and Resources Mapping Project in Beds, Herts and Luton identify the needs of individual practices
2. Community and Care Home End of Life Education Programme in Beds, Herts and Luton (increase in PPD from 51% to 77%)
4. 10th July 2012: Hospice of St Francis, Berkhamsted ([email protected]) Case Studies in End of Life Care (Advance Care Planning, Assisted Suicide, Psychological Distress)