Preparing for death is a pretty big subject. Indeed, preparing for the death of a loved one is an uncomfortable, distressing thought that we usually suppress or brush under the carpet. However, the unpleasant statistical reality means most of us will, at some stage, be in a position where we will be preparing ourselves and our family for the death of a loved one – and that is a bitter pill to swallow.
Over half a million people die each year in the UK and the number is growing as early baby boomers reach 70. So what do we need to do to? How can we lessen the trauma for the surviving friends and relatives by preparing for death?
Get the best care for your loved-one
While many elderly relatives will be in a care home or hospice – research by One Poll in 2014 highlighted that 97 percent of people do not want to go into a care home if they become ill or less able to cope. You might think that a care home or hospice is better, and in some cases this may be the case, but at Christies Care all our carers are trained in ‘End of Life’ care otherwise known as palliative care.
We know that the end of somebody’s life is a very important time and it is important that the right care is given and that the care is given in a manner that suits the person who is dying.
It is equally important that carers themselves stay strong. It is vital that carers can look after themselves and can manage the emotional effects of death and bereavement. A large part of our End of Life care training, therefore, covers ways for carers themselves to cope with this deeply difficult time and remain able to give their best care and attention to their client.
Our two day residential palliative care course is run by our in-house training team and has been developed with input from UKHCA and St. Elizabeth Hospice. It prepares all those who attend the course to support and assist the client with their daily needs towards and at the end of their life.
What does this course cover?
- Aspects of change as someone approaches the end of life
- Spiritual & religious needs
- Communication & documentation
- Collaboration with other professions
- Looking after yourself
- Managing death & bereavement
Attend to your loved-one’s general wellbeing
It may be obvious but the details of life towards the end are important. It’s important to make someone’s last time on earth as comfortable as possible.
Food – it’s all about them; what they want and what’s best for them (usually one and the same but not necessarily). Our carers are trained to ensure diets are medically approved so as not to exacerbate any conditions and make the client as comfortable as possible.
Accommodation – Depending upon the loved-one’s mobility, this should ideally be on one floor with easy access to the bathroom. Any special equipment, such as hoists, walk-in baths, gripper mats and grab rails should be fitted professionally. Our carers are trained with small and large handling aids to help even the most immobile clients move around freely. Of course the accommodation should be kept at a comfortable temperature and as bright and airy as possible.
Medication – This is an area for the professionals and they will give you clear instructions. Our carers are trained to monitor and record medication intake and client reactions. Some clients take up to 20 pills a day so this is an important area to keep on top of – making sure your loved one is as healthy as they can be in the circumstances.
Comfort – Whether it’s a television, old photograph, visits from friends, pets, days out, favourite treats, take-away food, a seasonal party or grandchildren’s visits, remember that little things can make a big improvement to a loved one’s comfort.
Life as usual – Many of the older generation grew up in a post war society where the population had little in the way of luxury but just got on with rebuilding the nation and their lives. Often the last thing they want is a fuss and so a good dose of normality is often a tonic. Christies Carers are trained to detect when a client is getting irritated at being fussed over and use techniques as simple as minor domestic chores to occupy them productively.
A very useful website http://www.dyingmatters.org/ undertook a survey in 2014 that showed that although most people in Britain (70%) were happy to discuss their death, almost all of them hadn’t! This lack of planning meant that even though 67% wanted to die at home most people die in hospital.
This willingness to discuss death means there’s no excuse for not preparing for death. Take the opportunity to prepare your family for a loved one’s death in areas like: –
Wills – This legal document (gives instructions on what they want to do with the possessions (particularly money and assets) they leave behind. You should discuss this with your loved one. Especially to find out if a will exists and where it is. If it doesn’t exist then it is extremely important that you get one. If you die without a will, your money and property will be divided according to fixed, unchangeable rules. For more on wills, please see Wilson Browne’s guide to wills: http://www.wilsonbrowne.co.uk/guides/a-guide-to-wills/
Funeral – People tend to have a lot of opinions on how they want their funeral. It is worth a conversation to answer questions like the nature of the service, cremation or burial, the place and who should attend. You can also get into details like music and flowers – being sensitive as to whether the topic is welcomed or not. Also don’t forget to ask about the option of organ donation. Many funeral directors will visit, to help plan a funeral.
Lasting Power of Attorney (LPA) – This is a legal document that lets your loved one appoint one or more people (attorneys) to help them make decisions or to make decisions on their behalf. An LPA is an extremely important document – without it, social workers can make decisions about you – whatever your family wants. For more information, please see RadcliffesLeBrasseur’s guide here: http://www.rlb-law.com/briefings/tax-private-client/lasting-powers-attorney-health-care-financial-decisions/
Dependents – This can be a tricky one. How do you discuss a loved one’s wishes for the future care of dependents (spouse, partner, older dependent children or siblings, companions) without overwhelming emotion? Ultimately it has to be done and if the conversation is planned then your loved-one has time to gather their thoughts, perhaps in writing, so that your family, and those affected can prepare for their death.
Property – This is not so much about property ownership, which will be covered in a will, but details like where important documents are – any keys or alarms as well as bank, computer, social media, online account and other passwords.
Families that have a loved one who is dying may not want to talk about it but they may also be very grateful for someone to take up the reigns and help to get everything in order. Tread carefully, this requires a sensitive approach.
Children need to be prepared with even more sensitivity – addressing the issue in a matter of fact way with some often disarming questions. There is a good leaflet about preparing children for death and bereavement here.
What you can’t really prepare for is the reaction of your family and yourself when the inevitable happens. You are dealing with grief while simultaneously comforting others.
There will be a number of people affected and who will need varying levels of and types of support. In most cases the spouse or closest child will lead the administrative process. They may look strong but it’s important to make sure they have the support that they need too.
Sensitive carers – This is another area where well-trained, live-in carers can be a real comfort as well providing top-class palliative care. One of the real advantages of having a Christies Care carer is when a husband and wife are cared for together. This effectively halves the per capita cost and eases the burden on the ‘carer spouse’. Our carers have a 24/7 Carer Support Team behind them making sure the carer stays strong, looks after themselves and manages their emotion so they remain able to give their best care and attention to their partner or spouse.
What’s expected of the family – Often family members have a sense of duty. They feel as if, in such a terminal event, they should be doing something despite their own bereavement. In this instance it is helpful to reassure them that everything that can be done is being done and that the best thing they can do is carry on as normal. This is especially useful if their wish to help is directed towards simple things like talking, companionship and reminiscing. Older people often enjoy talking about their lives and this is valuable to them and the family.
Wider family considerations – Distant relations and friends, whether nearby or in other countries also want to be kept informed. Social media and email enable two-way communication between parties and will enliven a loved one’s last time on earth. It may even provide the opportunity to clear up any loose ends!
Frequent not irritating contact – The mere process of writing an article like this highlights how this situation can be over-thought. Those who know they are near death are just as prone to becoming irritable at being fussed over as the rest of us. Dying people are living and should be treated accordingly. Be sensitive to the timing and frequency of contact. There is so much room for personal preference.
Company and companionship – This is a diverting and pleasurable way to spend time or a tiresome nuisance. Unlike family Christies carers are trained to provide companionship when it is needed and withdraw when it is unwanted. This is a sensitive judgement and families should be prepared to accept that tiredness, rudeness or requests to be left alone are not personal affronts or criticisms but all part of easing a loved one’s final time.
Most people want to die at home surrounded by their family and friends. Like the death scene in many a Hollywood film; a sick person looking surprisingly well and serenely cogent lays in an enormous bed surrounded by concerned and weeping relatives, lovers and friends to whom they mutter their last words. While this tableau may be anachronistic it’s what a lot of people have in mind despite the majority of us dying in a hospital, care home or hospice.
Preparing your family for a loved one’s death is a complex but worthwhile exercise that incorporates a number of elements. Significant among these elements is care and, given that most of us wish to be cared for at home and that Christies Care carers are trained in End of Life care, it makes sense to explore in-home care from Christies.