Citing this year’s report by the Parliamentary and Health Service Ombudsman – Dying without dignity – the article begins by questioning why it is that there remains such a shocking problem with care for dying people in hospital. It further questions why so many patients still die in hospital given that many want to spend their last days at home.
The authors identify the cause of the problems to be cultural, both in how society at large treats death (we are “anxious” and “convinced of immortality”, they claim) and more specifically with how hospitals focus their attention on cures.
“It takes confidence and courage,” write Drs Taylor and Chadwick, “for doctors to tell the truth, that the treatment is not working and that time might be short, but these conversations are critical to opening up different possibilities for the future.”
In proposing solutions, they argue that hospitals can learn from hospices, referencing the ‘Hospice Friendly Hospitals’ project in Ireland. Small changes, such as making sure that people can see a view from their room, or adding some greenery to the ward, can make a big difference.
Other recommendations include encouraging stronger partnership working between palliative care and elderly care teams, as well as a call for hospitals to use volunteers (as happens in King’s College Hospital, London) to perform small tasks – offering cups of tea and helping families find their way around – to make the time patients and their families spend in hospital more bearable.
“Small changes,” the authors explain, “add up to a tipping point of improvement which is long overdue.”
They conclude: “we need commitment to support system and attitude change from the highest level of hospital leadership to make our hospitals places of safety, welcome and trust once again, and not just in the last days of life.”
Read the full article on Palliative Medicine’s website.