One of the hardest, yet inevitable aspects of working in a residential care home for older or vulnerable people is that there will be residents who are coming to the end of their life. While end-of-life care can involve some highly specialist medical skills, there is also a great deal that care staff can do in other ways to make this difficult time pass as comfortably as possible for everyone concerned.
Open communications
When someone is dying, it is a confusing and distressing time for both them and their loved ones. Care staff can help reassure and provide information by keeping in regular contact, involving the person as much as possible in decision-making and answering questions. Care Vision can help you keep track of the person’s medical treatments and medications to assist with this.
Prioritising the person’s wishes about the type of care they wish to receive, where they want to be looked after and any other instructions is very important. Again, advanced care planning and directives can be recorded in Care Vision to ensure that everyone who needs to access the information can do so easily.
Comfort and pain management
Working to keep the person as comfortable as possible in their final days or hours can make a huge difference to the process for them and their loved ones. Care staff should focus on identifying and managing symptoms such as pain, nausea, anxiety or difficulty breathing. Again, Care Vision’s eMAR system can track medications to ease painful symptoms, while the Nurse Call alert feature can summon emergency medical help when it is needed.
Ensure the person is kept warm and clean, offering food and drink as required. Note that people can often change their eating and drinking habits, or stop consuming food and fluids altogether in the run up to their passing. A vaporiser in the room can help ease breathing in some cases.
Dignity and compassion
The most important thing for people facing the end of their life is to maintain privacy and dignity. This is particularly essential for personal care and when they are in their very last moments of life. While a busy care home can have a lot of demands of care staff’s time and overall resources, this should always be prioritised Keep the environment private, calm and quiet, minimising distractions and only allowing those who absolutely must be present to be in the room.
Encourage family members and close friends to spend time with their loved one, perhaps reading to them or playing music. Ensure that staff are trained in providing dignified, compassionate care that eases the anxiety and stress felt at these difficult times.
Caring for loved ones and caregivers
Witnessing, or even knowing about someone you love receiving end-of-life care can be very distressing, especially if you are not medically trained and do not know what to expect. Care home managers and staff can support the families and loved ones of their residents facing this situation in a number of ways. Offering support, compassion and practical advice can be very reassuring, as can a regular supply of cups of tea and gentle chats.
Carers can encourage family caregivers and relatives to take breaks from visiting and sitting with their loved one, even if it is just to make a snack or take a short walk in the garden for ten minutes. Simple self-care activities like these can often help people facing the loss of a loved one to regain some strength and energy at an impossibly difficult time.
Keeping friends and family members regularly informed about their loved one’s progress is important too, and can help them make decisions a round when to visit, and when to inform others about the situation at hand. Finally, care staff can help relatives by providing the details of bereavement services, funeral directors and celebrants to help with the post-death planning, arrangements and decision-making to come.