Wednesday, 23 January 2013

Liverpool Care Pathway - The Writing On The Wall

These comments posted here -

 Re: Liverpool Care Pathway

Post by patrick11 on Wed 16 Jan 2013 - 23:46
BigJen wrote:HS - I think your posting is not helpful.

The Liverpool Care Pathway, used properly, is a dignified end for many people. For most it is a matter of hours or days, and as hardly anyone would starve to death in that period, what you say is not right. The LCP allows carers, both professional and family/friends, to concentrate on keeping the patient/loved one comfortable and pain free in their last hours or days. Having seen my own mum being what I consider "force-fed" when she did not want or was not able to eat was almost unbearable. She has advanced AD and is clearly shutting down.

No one can give permission for another adult to undergo any treatment, so no one can formally "agree to the pathway". If the patient has no capacity then doctors will do what is in the best interests of the patient, albeit they will usually, as a courtesy, discuss it with family.

I am not sure how Article 2 is applicable. Who is depriving who of life? Merely no longer keeping someone alive by drips and PEGs etc is not "murder" which you seem to imply.



We have just over the last 7 months witnessed several patients die on the liverpool care pathway whilst visiting our mother who is in hospital; twice our mother has been put on it and twice we demanded continuation of treatment; and twice our mother has pulled through

for what we have witnessed is very harrowing, we have witnessed patient's suffer in pain whilst waiting for doctors to come and give morphine injecions or to authorise it for the ward staff to give it; to ease their pain, sometimes the duration of our visit 2 hours or more, to see the twisted facial looks on their face as they die slowly is a horrifying thing to see

there can be no dignity in dying gripped in pain, When all treatment is stopped fluids, food, all vital organs start to shut down, and that is very painfull, yes they do die of malnutrition and dehydration, that is the exact cause of death, Im sorry but that is what we have personaly witnessed,

And yes it is hard; very hard to see your relative having to be fed by tube,Ect, but remember they will also be allegedly kept pain free whilst being treated, for us when our mother has had enough she will pass peacefully in her sleep with no pain naturally; the lord gave life only the lord should end life,

Here is a quote from a leading specialist

Professor Pullicino said he had returned to work after a weekend to find the patient unresponsive and his family upset because they had not agreed to place him on the LCP.

‘I removed the patient from the LCP despite significant resistance,’ he said.

‘His seizures came under control and four weeks later he was discharged home to his family,’ he said.

Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically.

 Re: Liverpool Care Pathway

Post by patrick11 on Thu 17 Jan 2013 - 2:55
Update to my last post


Some hard facts; 16th january visit to see our mother; First thing noticed lips stuck together no nurses had attended to give comfort CARE; such as moisten her lips clean her mouth, oxegen Nasal tubes not in place, positioning almost hanging out of bed; not comfortably positioned, enteral feeding tube also paracetamol IV drip only things correctly in place ; Kicked Ass Big time

Mother responsive knew we were there; smiled held hands, played her favourite tune theme of titanic My heart will go on, smiled and cried usual effect; Meaning mother was aware of her family around her and compleatly understanding of sound, played some Hancocks half Hour radio shows through ear phones; she smiled and giggled; precious moments to behold and to remember;

Doctor arrived, Can i have a word he said; so off i went to a private room he asked that we should be thinking of End of life; why said I; what clinicle proof have you to say that my mother is dying

He states that it is undignified to prolong life and they need to act in the best interest of the patient, i asked if Mothers lungs, liver, and kidneys are failing, he states NO;

So then i asked why not continue with treatment; he states well, because there would be no Quality of life ( I,e. referring to her Dementia;) and that she (mother) would eventually pass away;

I reminded him that our mother had arrived at Hospital in a criticle state but responded to treatment and continues to do so; So why ask us to consider end of life whilst she is responding to treatment, his response again was we have to act in the best interest's of the patient

well the up shot is; Mother is and has and continues to responded to treatment as given, also respondes well with family;

the question is why would they want to end our Mothers life; Well in short 

Mother is a fully funded care patient with a continuing care bed in a nursing home paid for by the N.H.S @ Something like £700.00 pounds plus per week, now in hospital the care bed is in excess of £3,500.00 per week = £ 4,200.00 per week with nursing home and Hospital cost's

That is what they are concerned about; and not the patient; the patient is worth less than the cost of providing meaningfull CARE


A letter to The Examiner -

Pathway should lead to a pain-free death
by Val Javin, Huddersfield Daily Examiner Jan 18 2013

IN THE debate on the Liverpool Care Pathway the issue of pain management has not been mentioned.
Personally, I have no objection to facilitating the dying process and allowing people to die in a dignified manner.
However, a fundamental element of any practice employed must be effective pain management.
In my experience this is where the Liverpool Care Pathway (and variants) fails.
In the past 12 months both my parents died on the variant Liverpool Care Pathway used by the Calderdale and Huddersfield NHS Trust.
For both parents medication and food/drink were withdrawn to support the dying process.
Obviously withholding basic physiological necessities in this way has medical implications. But assurances were given that both parents would be comfortable and pain free. However, this was not the case.
My mother was unable to communicate for days before her death and at times was obviously in a great deal of discomfort.
My father was able to communicate and only hours before his death said ‘they say they can control pain but they bloody can’t’.
The aim of the Liverpool Care Pathway is to achieve the best quality of care at the end of life, however, the healthcare professionals are failing in this respect whilst ever people die in pain like my parents.
Name and address supplied

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