End of Life Care
End of Life Care Video Library
Gold Standard Framework
This framework looks to support patients with life limiting conditions where treatment becomes for symptom control and not cure. We hold a register of all patients affected. You will be assigned a Primary GP and Secondary GP to ensure continuity of care. Where possible you will see your primary GP who will work with you to plan ahead with your care and provide pro-active not reactive health care. We hope by ensuring continuity that we will get to know you and your family and deliver the highest level of care. When you or your family call for advice or an appointment please advise the receptionist who your primary GP is so that they can contact them for you directly. If a Healthcare Professional wishes to speak to your GP please advise them that your Primary GP is best placed to discuss your care.
We hold monthly meetings with the district Nursing team, Community Matron, Palliative Care team and Dr Wilson who leads on Palliative Care.
Maggie's Centre (Cheltenham)
Maggie’s offers free practical, emotional and social support to people with cancer and their families and friends. Help is offered freely to anyone with any type of cancer. Simply drop in to The Lodge, College Baths Road, Cheltenham, GL53 7QB.
Telephone: 01242 250611
Website: www.maggiescentres.org/cheltenham
Food First
The following information can help you to increase your calorie
and protein intake if you have a poor appetite or have lost weight.
Please view: Dairy free
Please view: Food First Booklet
Planning ahead
For some patients and their families, it can be helpful to look ahead. Planning ahead means thinking and talking about how you wish to be cared for in the final months of your life.
www.macmillan.org.uk/EndOfLife
www.dyingmatters.org/p
www.ageuk.org.uk/thinki
What happens in the final days
In the final days of life your body may undergo these changes. The leaflets below can help to prepare you and your family with what may happen.
Just in Case Boxes
Just in Case Boxes are available for GPs to prescribe in the Forest of Dean and are being rolled out across Gloucestershire. This is a box containing anticipatory medication that a person may need for the main symptoms at end of life (pain, nausea, secretions, agitation). It is kept in the person’s home ‘just in case’ it may be needed and is particularly useful at evenings and weekends if urgent or emergency services have been called out.
What to do After Death
The death of your loved one will be a challenging and difficult time. We hope that these resources can clearly outline what you need to do. It’s important to realise that when your loved one does die that you feel comfortable to deal with it in your own time.
When you are ready call the GP or District nurses and they will attend. If this happens out of hours you will need to call the out of hours service on 0300 421 0220 and explain that your loved one has died and that this is an expected death. Please do not call 999 if this is an expected death.
When they have been and you are ready, you can contact the funeral director who will make arrangements to take your loved one to their Chapel of rest.
You will need to contact your GP and they will talk through what has happened and issue a death certificate. This is then used by you to register their death. If your loved one wishes to be cremated a separate form will be completed by your GP. This form then has to be signed by a further two GPs.
They may contact you to talk through what has happened. This is standard practice and whilst difficult for you please do not be concerned.
www.gloucestershire.gov.uk/register-a-death
Coping with grief
The death of a loved one affects us all in different ways. There is no right way or right time to grieve. Be kind to yourself and take each day as it comes. There is support if and when you need it.
Bronze Level Practice
Aspen Medical Practice are proud to have been accredited as a bronze level practice for training and embedding ReSPECT Into our practice culture and care.
ReSPECT
The ReSPECT process provides health and care professionals responding to an emergency with a summary of recommendations to help them to make immediate decisions about that person’s care and treatment. ReSPECT can be complementary to a wider process of advance/anticipatory care planning.
The ReSPECT plan is created through conversations between a person and their health professionals. The plan is recorded on a form and includes their personal priorities for care and agreed clinical recommendations about care and treatment that could help to achieve the outcome that they would want, that would not help, or that they would not want.
Website: www.resus.org.uk
Charlie's - Gloucester
Charlie’s Community Cancer Support and Therapy Centre offers friendship, support, holistic therapies, activities and events to help anyone affected by cancer in Gloucestershire, people with and post cancer, their families and carers.
Telephone: 0778 654 7439
Website: www.charlies.org.uk
Email: charlies2014@yahoo.co.uk
Please read: Charlie’s Twighlight Evening poster
Please read: Charlie’s Monthly Meeting Schedule
Malnutrition Pathway
Managing Adult Malnutrition, including a pathway for the appropriate use of
oral nutritional supplements (ONS).
Website: www.malnutritionpathway.co.uk
Please view: Your Guide To Making the Most of Your Food
Please view: Nutrition Support in COPD
Hospice Care
GPs and district nurses may take advice from the Specialist Palliative Care Team who may also ask to visit you at home or see you in clinic. If you are finding symptom control difficult sometimes a short visit to one of the hospices can helpful to stabilise your symptoms and get you back home feeling more comfortable. Hospices also offer daytime activities which patients and their families can find helpful.
Hospices are able to provide specialist care and a range of holistic (physical, psychological, spiritual and social) support to people with a life-limiting illness, their carers and families.
There are three hospices in Gloucestershire:
Leckhampton Court Hospice (Cheltenham) provides in-patient hospice beds, day hospice care and hospice at home care (Cheltenham, Gloucester and Tewkesbury)
Great Oaks Hospice (Coleford) provides day hospice care and hospice at home care (Forest of Dean)
Longfield (Minchinhampton) provides day hospice care and hospice at home care (Stroud and Berkeley, Cotswolds and Gloucester)
Caring for Someone Nearing the End of Their Life
Caring for someone who is nearing the end of their life is very difficult. This can be a sad and challenging time for you; you may want answers to questions which are difficult to ask.
This leaflet gives you details about several organisations that may be able to help:
Funeral Planning
As part of the planning ahead process some patients wish to think about what type of funeral they would like, who they would like to be there and whether there is anything in particular, they would like to happen.
Whilst these can be a difficult conversation many people find this a helpful process and for the loved ones who organise funeral arrangements after your death it can be a comfort to them that they are carrying out all your wishes exactly as you wanted.