11/23/2015
Caring for those who are at an advanced stage of life can be both challenging and rewarding. What cannot be denied is that there is a burden of responsibility on the carer to make the client’s remaining time as comfortable and enjoyable as possible.
This article is designed to help those carers who are dealing with clients reaching the end of their lives, and we aim to offer practical advice about how to make that experience as valuable as possible. It is aimed at non specialist workers and their managers.
Six steps programme
The National End of Life Strategy (DH 2008) produced an end of life pathway diagram to highlight the six steps required to provide good end of life care.
The six steps programme is based on these steps which are:
- discussions as the end of life approaches
- assessment, care planning and review
- co-ordination of care
- delivery of high quality services
- care in the last days of life
- care after death
The Six Steps Programme was originally developed as a programme of learning for care homes to develop awareness and knowledge of end of life care. It has been implemented successfully in other settings and is now being adopted throughout the country.
Expanding your knowledge through e-learning
e-learning for health and social care workers End of Life Care for All (e-ELCA) is a free and innovative e-learning programme which offers around 150 easy to use modules covering all aspects of end of life care. Some of the modules can be mapped to the end of life care qualifications. If you are a social care professional in England, you can access the e-learning by asking your employer to register with Skills for Care’s National Minimum Data Set for Social Care (NMDS-SC). You can then use the user registration code to access e-ELCA. A DVD version of the e-learning is available by emailing marketing@skillsforcare.org.uk.
Qualifications
The qualifications available to expand your skills regarding end of life care are:
- level 2 and 3 awards in awareness of end of life care
- level 3 certificate in working in end of life care
- level 5 certificate in leading and managing services to support end of life and significant life events.
According to skills for care, the qualifications help adult social care employers support the National End of Life Strategy and also build on the work of common core competences and principles for end of life care.
Different job roles
It is essential that people in different job roles work together in order to provide excellent end of life care, including the person who is dying and their carer.
End of life care and skills around the person
Work has been taking place to encourage better working between organisations and communities to improve skills and knowledge around end of life care. For example, hospices can provide good information to people in communities to enable them to support people to die well at home.
Core competences for effective delivery of end of life care
The Department of Health’s 2008 End of Life Care Strategy sets out what adults reaching the end of their lives, and their carers, can expect from the services provided to them.
The National Institute for Clinical Excellence (NICE) draft End of Life Care Quality Standard, published for consultation in the spring of 2011 and due for final publication in the autumn of 2011, emphasises these expectations.
The key points are summarised below, and are also taken from the skills for care site which provides a meticulous guide regarding end of life care:
1. A diagnosis that is arrived at as quickly as possible, with information about prognosis and treatment options explained sensitively, appropriately and in a jargon-free way.
2. Information that is provided as and when it is needed, in a format that is appropriate to their needs and abilities.
3. Regular assessment and care planning that includes discussion about current and future care, is person-centred, and takes account of practical, physical, psychological, spiritual, social and religious needs and preferences.
4. Support for carers and family members including children, recognising the impact of bereavement upon them.
5. Care and support delivered seamlessly, by multidisciplinary teams working together to meet identified needs.
6. Care and support that is delivered by practitioners who understand the person’s current medical condition, care plan and preferences.
7. Care and support that is delivered by workers who are competent, have the appropriate knowledge and have the right skills and attitudes needed to provide safe and effective care for people approaching the end of life.
8. Care and support that is available when it is needed, and at home if that is their preference.
9. Care and support that meets practical, physical, psychological, spiritual, social and religious needs and maximises independence and social participation for as long as is possible.
10. In the event of an unexpected crisis, prompt, safe and effective urgent care; at whatever time of day or night it is needed, appropriate to their needs and preferences.
11. Safe and timely transfers if they need to be moved, so that they receive care in the place most appropriate to their needs and preferences.
12. Specialist palliative care when it is needed, and that takes account of needs and preferences.
13. Timely identification of the last days of life, and care delivered at that time that is individualised to their needs and preferences and ensures access to, and administration of, prescribed medication.
14. Sensitive communication with carers and families who are newly bereaved, with timely verification and certification of death, information including details of any possible coroner involvement, and practical support appropriate to their needs and preferences.
15. Emotional and bereavement support appropriate to their needs and preferences, for people closely affected by a death.
Written By:
Daniel James
www.danieljamesbio.com
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