This article examines and summarises the role of nutrition and the dietitian in the final stages of palliative care. The recent publication of One chance to get it right (NHS England, 2014), highlighted the need for a change in the approach to food and drink, especially when caring for those patients who are at the end of life. There is a clear need for documentation and formulation of clear, patient-centred and effective care plans, as it is vital that food and drink are offered, as long as it remains safe and is not harmful to the patient.
The UK has an expanding elderly population, which means that in the future nurses and clinicians who work in community-based units, such as nursing homes and hospices, will increasingly encounter age-related conditions such as palliative oedema and mixed aetiology ulceration. This article looks at duomed soft®, (medi UK, Hereford) a new hosiery solution, which is not only easy to apply, making patient self-care more likely, but also provides consistent mild compression in a format that is more cosmetically acceptable to patients.
Helen Butterfield, Leg Ulcer/Dermatology Specialist Nurse, Oxford
The Liverpool Care Pathway (LCP) is an integrated pathway developed to enhance the quality of end of life care for dying patients and their families. The purpose of this study was to introduce the LCP into a community setting and continually audit its use to provide statistical evidence as to whether the use of the pathway improved documentation in the three key areas of initial assessment and care, on-going assessment and care after death.
Acknowledgements:
Hertfordshire Community Nursing Team
West Hertfordshire Community Macmillan Team
Three GP Surgeries, Hertfordshire
Liz Garrood, End of Life Care Strategy Educator, Hertfordshire
Sarah Russell, Director of Education and Research, Hospice of St Francis, Hertfordshire.
Cheryl Manners, Team Lead, Community Nursing and Therapy, Hertfordshire.
Sharon Roberts, Community Macmillan Nurse, Palliative Care Service, Hertfordshire.
Article accepted for publication: February 2013
Caring for people approaching the end stages of their lives can be a challenging yet immensely rewarding area in which to work. Front line staff such as nurses and therapists are the visible face of care provision; however, the organisation and co-ordination of service provision from support and administrative staff can have a tangible impact upon the quality of service provision received by the patients and their families. This article aims to give a brief outline of how one community healthcare organisation developed a system and associated processes to provide a single point of referral for end of life care from a range of community nursing services.
Sue Pender PGDE, BSc (Hons) RN, Modern Matron, City Health Care Partnership Community Interest Group (CIC), Priory Park East, Hull
Fiona Pearce, NVQ, IV, RSA, Secretary to the End of Life Care Team, City Health Care Partnership CIC
Article accepted for publication: July 2012
Chronic obstructive pulmonary disease is a progressive and non-curable disease of the lungs, which is known to be on the increase. Unlike cancer, end-stage COPD is more difficult to recognise and to determine a prognosis. Symptom control, open discussions with patients and their families along with advanced care planning are germaine to delivering good care. This article outlines how to recognise end-stage COPD and discusses the issues in planning end-of-life care and management to facilitate a comfortable and peaceful death.
Margaret Barnett RGN, MSc in Nursing Studies, Diploma COPD & Asthma, COPD Nurse Specialist
Article accepted for publication: February 2012
The importance of a well trained workforce to support the needs of those approaching the end of their life and the needs of their carers is readily acknowledged, yet relatively few healthcare professionals are specifically trained to manage palliative and end of life care. Access to suitable education is often patchy and many health and social care providers have difficulty accessing relevant education and training. This paper reflects on a Palliative and End of Life project for assistant practitioners being delivered in the North West of England.
Joanne Smith BA Hons, MSc, PGCE, Programme Leader, Foundation Degree, Health and Social Care, University of Bolton
Trish Brown RGN, PGDPNS, MA Gerontology Work Based Education Facilitator, UHSM Academy
Article accepted for publication: February 2012
Alison Mathew & Val Newall describe a joint initiative between health and social services.
Kathy Morris discusses some of the causes of anorexia in patients with advanced terminal disease and offers guidance regarding how community nurses can help carers and patients overcome this problem.
Jan Hammett gives a descriptive account about how a series of ten palliative care workshops highlighted the need for more accessible education in the field of palliative care.
