Liverpool Care Pathway - It's Not the Crisis, It's What You Do With The Crisis

It is how we care for the living, through their lives until the end of their lives, that determines a compassionate society.



They are trained in how to present things to your disadvantage. It is achieving the impossible by making it desirable.

It's grooming.

Let's see...

When they survey for 'customer satisfaction' - the so-called PROMs (Patient Reported Outcome Measures) - do they ask the patient...? How can they? The patient has been consigned to the hereafter. That is the business of the Hospice and the care pathways, all still up and running.

They will ask the family...

It is wholly a subjective view, then, and one of perception in that it is one reported by the perceiver of the death and not by the person who has died.

We all know what Midazolam does...

This is Health Management and Policy alert from The King's Fund with a report from Compassion in Dying –

This report highlights the need for better advance care planning at the end of life and the urgent need to put in place workable guidance to replace the Liverpool Care Pathway as soon as possible. The report found that almost half of those who have lost someone close to them through a short or long illness, feel their loved one died badly (45%). In cases where the dying person had recorded their end of life wishes, relatives and friends are more likely to report that they had a good death (58%).

At a pivotal time for end of life care in Britain the need for advance care planning is reinforced

With the decision to phase out the Liverpool Care Pathway and replace it with personalised care plans, the Divided in Dying report comes at a pivotal time for end of life care in Britain.  We know that planning for the end of life and good communication in end of life care are key to ensuring people die well, we must now shift the focus to ensure that this knowledge results in a change in practice and attitudes. The division between those dying well and those dying badly must become a problem of the past.”  - Compassion in Dying

"With the decision to phase out the Liverpool Care Pathway..."

As Rahm says, it's not the crisis, it's what you do with the crisis to advance your own agenda.

This is Age UK with the same report –

End-of-life care plans are a crucial factor in ensuring individuals experience a compassionate death, a new report has concluded.

The charity Compassion in Dying also said its report highlights the need for workable guidance to be put in place as soon as possible.








Hmmm...

Let's see. 

The report found that almost half of those who have lost someone close to them through a short or long illness, feel their loved one died badly (45%). In cases where the dying person had recorded their end of life wishes, relatives and friends are more likely to report that they had a good death (58%).

Where a Death Wish has been recorded (as in the 'My Wishes' Invicta program on the East Kent EoL register, for instance) 58% of people had a 'good death'.

Take another look at the figures, and you'll see that, actually, 55% of people not on a death plan, apparently, also had a good death.

It's not what you say, it's the way that you say it. What is their agenda? It is the life limiting Communitarian Complete Lives System.

The focus on EoL care has less to do with compassion and more to do with the programme to limit life.

And here is the Communitarian Complete Lives System treatment priority curve:

You have made a Living Will or Advance Directive.

The term advance directive (increasingly being replaced by the term advance decision) means a statement explaining what medical treatment the individual would not want in the future, should that individual 'lack capacity' as defined by the Mental Capacity Act 2005. The term 'living will', whilst helping people to understand the concept, is somewhat misleading in that, unlike a will, it does not deal with money or property. Moreover, it can relate to all future treatment, not just that which may be immediately life-saving. An advance directive is legally binding in England and Wales. Except in the case where the individual decides to refuse life-saving treatment, it does not have to be written down, although most are and a written document is less likely to be challenged.- Patient.co.uk

You have included all the parameters for treatment or non-treatment and you are sure you have pretty much covered your bases...

I, (name) of (address) wish the following to be considered in the event of my incapacity to give or withhold consent for medical intervention.

If ever I am unable to communicate and have an irreversible condition and I am expected to die in a matter of days or weeks, or if I am in a coma and not expected to regain consciousness or if I have brain damage of disease that makes me unlikely ever to recognise or relate to people then I want treatment only to provide comfort and relieve distress, even if this may shorten my life. I do not want treatment that can only prolong dying.

I consent to any acts or omissions undertaken in accordance with my wishes and I am grateful to those who respect my free choice. I reserve the right to revoke or vary these conditions but otherwise they remain in force.

If I am certified brain dead, should any of my organs be of value to others, I give consent to their removal for the purpose of transplantation. - Patient.co.uk

Hmmm...

"Even if this may shorten my life..."