Dr David Crichton’s blog: Talking about death is still a taboo subject

245This is a transcript of my column that was published in the Doncaster Star on Monday 29 August, 2016.

Talking about death is still a taboo subject in many Doncaster homes, even though it’s something we all have to face at some point.

Having been closely involved in organising end of life care health services in Doncaster I understand how difficult such conversations can be. But it’s crucial that they are discussed so everyone’s final wishes can be understood and planned for.

It’s important because the NHS wants more people who are nearing the end of their life to be given the opportunity to die at home if that is their choice.

The results of a survey that NHS Doncaster Clinical Commissioning Group ran last year indicate that the majority of Doncaster people do want to die at home. Being able to maintain a good quality of life and being able to die at home with loved ones around scored highly in our survey.

Around 3,000 Doncastrians die each year. Historically, over half of those deaths have taken place in hospital because locally we haven’t always had the services available to support people who have wanted to die at home.

But things have been changing. We are developing the staff and resources to make a home death as comfortable as possible, including ensuring that the patient’s symptoms can be managed effectively and efficiently. Every person will have different symptoms, depending on their condition and the kind of treatment they may be having.

This is an area we have been concentrating on recently and I’m pleased to say that this week marks the launch of a key new development in our local end of life care.

Working with Doncaster’s high street and hospital pharmacists we are introducing Just in Case boxes for patients who are in the final stages of their life.

Each box contains a small supply of medication for those patients who choose to be at home, to help relieve symptoms such as pain, shortage of breath and sickness. The medication may not be needed but it’s there ‘just in case’ to save the time involved in getting a prescription if it is required.

Community pharmacists are supporting the scheme by holding a stock of the boxes at selected locations, so there is good geographical spread across the borough. Local GPs will authorise a pack to be dispensed a patient.

The medication doesn’t have to be kept in a fridge, just in a safe place at home. Each box comes with details of the medication inside and what they are used for so the patient – or their family – can discuss their use with the GP or community nurses that are providing care.

The box contains enough medicines to last until more can be supplied if the symptoms don’t go away, and any unused items should be returned to the local pharmacy for disposal.

This scheme is another step along our path towards ensuring that Doncaster people can have a good death at home.

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