New report calls for increased support around end of life care

A new report into the end of life care for older people in extra care housing is calling for more support for staff and improved cross sector working to help promote dignity and choice for older people and their families as they near the end of their lives.

Is it that time already? details the findings of a six month service improvement project by the older peoples housing and care organisation, Housing 21, and the National End of Life Care programme.
The project found:

It became more normal for extra care staff to talk and think about end of life care issues;
Staff began to recognise signs of deterioration at an earlier point and felt better equipped to respond;
Health, housing and social care professionals wanted to proactively plan how extra care schemes could support end of life care;
Health professionals began voluntarily to offer additional support to scheme staff;
Extra care staff knew more about what local specialist services offered, and how to access these.
Report co-author Sarah Vallelly, research manager at Housing 21 said: The combination of the growth of extra care housing and the personalisation agenda brings the need for appropriate end of life care into a very sharp focus.

Death and dying is a complex and difficult area but older people do think about it a lot. Choice should not be eclipsed just because someone is terminally ill.

Recommendations from the report include:

Extra care housing providers should incorporate a basic introduction to end of life issues as part of staff induction so that the issue is embedded in professional practice from the outset;
Specific training for extra care managers and staff should include new arrangements under the Mental Capacity Act 2005; symptoms of terminal stages of life and technical knowledge of what to look for, report and record; information about local services and how to access these; and bereavement support;
Clear and concise information about extra care housing is needed for tenants, families and professionals across the health, housing and social care sector;
Ensure tenants and their families have the chance to discuss and record their wishes;
Policy makers and service commissioners should ensure that extra care housing is seen as part of the continuum of living at home, as part of the community rather than in the context of care homes;
Ensure there is appropriate specialist provision for people with dementia or those with mental capacity issues;
Local operational staff from all sectors need to develop opportunities to come together to discuss how they can improve end of life outcomes for older people.

Claire Henry, director of the National End of Life Care programme, added: End of life care is not just the responsibility of the National Health Service, and there is no one size fits all formula. This project shows the importance and value of close joint working between professionals, and how such an approach can make a tangible difference to older people and their families.

Copies of Is it that time already? and more details of the project are available from Housing 21 on www.housing21.co.uk or the National End of Life Care programme www.endoflifecareforadults.nhs.uk.