Saturday 27 July 2013

Liverpool Care Pathway - Is It Who You Are That Counts?

Is it really a matter of who you are whether you get heard or disregarded, whether you get listened to or not...?



Kate Granger tweeted:

"Peaceful, pain free, holding her hand and after mouthcare with sherry..."
"Now I've had a first hand personal experience of the LCP Im even more convinced it is the right way forward..."
"Gran would not have wanted us moping around. She didn't do moping. So back to work to start my new job in orthogeriatrics it is..."

George Julian replied:
GeorgeJulian ‏@GeorgeJulian
"@GrangerKate Sorry for your loss but delighted to hear of the manner of your Gran's death. She'd have been very proud of you am sure."

Kate Granger blogged:

Last Sunday I sat and held Grandma’s hand as she died. She had advanced metastatic stomach cancer and was 90 years old. Unbelievably throughout her whole illness this was the first time she had ever been admitted. She had always said she wanted to stay at home but in the end the intractable vomiting was not able to be managed adequately in the community, so an urgent admission to the hospice was arranged with Grandma’s agreement.
When I went to see her on the Saturday in the hospice she said to me “I’m not sure I should have come here.” She was really  feeling the sedating effects of the anti-emetics and analgesia, having been such a bright, cognitively intact lady and the fact that she couldn’t articulate herself properly was really frustrating her. As the over protective medical Granddaughter I reviewed her medication with the hospice doctor and agreed a non-sedating regimen of anti-emetics which I took care to explain to Grandma so she was able to understand. That was the last time we had a conversation.
The following day we received that dreaded phone call to come to the hospice as soon as we could and found Grandma comatose.
Dear Kate, I do really offer my sincerest condolences at the loss of your Grandma. She was fortunate that you could step in and review her medication to get her put on anti-emetics without a chemical cosh. It enabled you both to have one last conversation. That must have been very precious to you both.

It does help to have someone who has some influence and who will be listened to to fight your corner.

As you say, Grandma wasn’t even sure she should have gone in…

And I was surprised to read nothing about the sherry in the blog post…

You have, no doubt, read of all the families who have actually pleaded with doctors and nurses to be heard and were cruelly ignored.

So...

It was a weekend. That fits...

Why was Grandma comatose the following day?

Further reading –

Liverpool Care Pathway – This Is Inexcusable



Just to round up - some good news, Kate...?

On Twitter, the Twits have been twittering:
Katherine Sleeman @kesleeman 

"Email from Bee Wee, National Clinical director of EoL care, on ‪#‎LCP‬: A 'clear plan' is in place for development of #LCP replacement. 1/3" 
"She states 'No need for each hospital or regional group to develop its own plans.' #LCP 2/3"
"Note that email from Bee Wee sent to all members of Assoc Palliative Medicine, and I have their permission to disseminate info. 3/3 #LCP"

Bang goes that personal care plan thing...

So, if you're working on your own 'end of days' plan, Kate, you'd better make a point of getting in there first to put your name to it.

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