Our Last Phase of Life project
The Last Phase of Life (LPoL) was a collaborative piece of work we did working across the five boroughs in North London (Barnet, Camden, Enfield, Haringey and Islington). The work is part of the North London Partners Sustainability and Transformation Plan.
A deep-seated unwillingness to talk about death generally has meant that finding out the needs and wishes of dying people and their carers’ and then to translate these needs into practice, is not easy.
We want to make sure that everyone has their say in the provision of health and care services, so it was vital that we heard from these voices which often go unheard.
The work was carried out with a hospice who have considerable experience in providing LPoL services, supporting and understanding the needs of people approaching the end of their lives and their families and carers.
Between November and December 2018 we spoke one-to-one with people about their experiences of last phase of life care.
- Support is generally good once it’s recognised that the last phase of life has been reached. Staff were praised for their skill, care and compassion.
- Some said that late diagnosis was often a problem, they felt that they were not taken seriously by their GPs.
- Having staff understand specific cultural and religious issues around death was important. Good experiences included the removal of foreign objects from the body as soon as possible after death.
- Many said that clear communication from everyone involved in the care of the dying person is essential to providing good care and support.
- The emotional needs of the immediate family are important, care givers should recognise this and explain last phase of life in clear simple terms.
Although every person has different needs in the last phase of life, there were similarities in what care patients and relatives considered good or not so good.
This is why we want everyone to be involved so we can understand the issues that affect different communities.
For everyone, good care in the last phase of life was a broad term and could refer to supportive care, treatment decisions, location of care and patient-doctor communication.
When we asked people what conversations they had about end of life care, and what was important for them about conversations on end of life; although many people find talking about end of life hard, everyone we spoke to agree on the importance of having a conversation about it.