Sharing Current Scottish Practice

Essentially for you

Family satisfaction with care in the in-patient unit IPU

Improving people’s experience of death, dying and bereavement

Improving the experience for bereaved families by developing a process for issuing death certificates

End of Life Care - What Matters?

Author(s) of poster: P Brooks-Young, S Fife, J Dunn, T Smith

This poster was designed initially for NHS Lothian Delivering Better Care Conference to share the key findings of unannounced visits to 71 ward areas across 14 sites within Lothian. This work helped to capture the delivery of end of life care within NHS Lothian in real-time, from the perspectives of patients, those important to them and health care staff.

Essentially for You - Stress Management for Carers. Impact of a Short Intervention on Carer's Stress

Author(s) of poster: Jenny Gilbert, Betty McGrory

Introduction: Family carers play a significant role in enabling people to be cared for at home in the last year of life. Yet many find themselves in a caring role and rarely identify themselves as ‘a carer’. Many describe their role as an overwhelming and stressful experience for which they feel ill-prepared.

Method: A 4-week stress management programme was offered to all carers from a hospice community caseload for 9 months from April 2013. Each session included structured reflection on the stresses of caring, explored how these could be managed and was followed by relaxation. An evaluation questionnaire was issued to participants in addition to a collective end-of-project focus group.

Results: Ten courses were delivered over 9 months. Out of 230 invitations, 52 carers were willing to participate. Evaluation identified a strong positive impact on carer’s wellbeing and affirmation that the stress management strategies discussed were helpful.

Conclusion: Recruitment was intensive but resulted in a good uptake. The group dynamic was a key success factor. The project enabled joint working between hospice and local carers groups. This will help build sustainable provision of this intervention for carers of people with palliative care needs.

Family satisfaction with care in the inpatient unit of a hospice

Author(s) of poster: Susan Campbell, Miriam Tadjali, Kirsty Cornwall

Using a validated questionnaire on the death of the patient, the opinions about admission to the hospice were sought from the ‘next-of-kin’. Pilot undertaken on 100 returned questionnaires. Comments and evidence provided shows that the carers felt the patients were treated with courtesy, dignity, respect and compassion. Symptoms of pain, breathlessness and agitation were assessed and treated well. Communication was of an excellent standard with all levels of staff and information was provided when required. Comments and suggestions were fed back to the team and where appropriate action taken. We also included an area for the name and address of the carer to be included if they wished to be contacted in the future to become involved in discussions regarding continuing improvements in Hospice care. From the pilot sample 38% completed this section and these people were invited to join a group looking into the needs of carers.

This group was supported by the Chaplain and senior nursing staff and is ongoing with the Family Care team. The survey is continuing - the comments and suggestions are important feedback to our multidisciplinary team.

Improving people's experience of death, dying and bereavement

Author(s) of poster: Mark Hazelwood, Rebecca Patterson

This poster describes the work of Good Life, Good Death, Good Grief (GLGDGG), an alliance working to make Scotland a place where people can be more open about death, dying and bereavement. The absence of such openness is a barrier to the delivery of person-centred health and care towards the end of life and to the development and mobilisation of individual and community assets in this field. 54,000 people die in Scotland each year and 224,000 people are bereaved. 29% of acute bed days are used by people in their last year of life. Nearly 1 in 10 patients will die during their current admission. Discussion is a pre-requisite for shared decision-making but is often absent in a culture reluctant to acknowledge death and dying. Low levels of public knowledge and awareness of practical, legal, medical and emotional aspects of death and bereavement limit capacity for self-management and provision of informal support. There is growing willingness by very varied organisations and individuals to promote greater openness about death, dying and bereavement. The presence of a national alliance to encourage and guide activity in this area is helpful in developing and mobilising individual and community assets.

Improving the experience for bereaved families by developing a process for issuing death certificates

Author(s) of poster: Norma Langford, Deputy Charge Nurse, University Hospital Cross house; Josaleen Connolly, Macmillan Project Lead, NHS Ayrshire and Arran

I have undertaken an education programme delivering practical palliative care through a distance learning module and placement shadowing members of the various specialist palliative care teams in hospital, community and at the Ayrshire Hospice. The education was provided by the University of the West of Scotland and the overall project was funded by Macmillan Cancer Support. This programme provided me with the knowledge, skills and competence in delivering general palliative care to patients who were admitted to Ward 4C where I work. I was concerned that the process for issuing the death certificate for the deceased sometimes caused unnecessary additional distress for families. Without a death certificate it is difficult for families to finalise funeral arrangements or to begin to inform other agencies that the person’s death has occurred. I felt there were a number of simple changes that could be made. I based my approach on the premise that families’ preferences should determine the way in which they obtained the death certificate. This small change has now become standard practice and has helped to minimise distress for families by creating a simple, clear and compassionate approach for handing over a death certificate to a family member.