There was a lot of good sense talked during yesterday’s Westminster Hall end of life care debate, on which the government is consulting at the moment, and in particular when discussing the Liverpool Care Pathway (LCP).
The LCP is designed to manage the withdrawal of unnecessary treatment given to dying patients to relieve suffering, and has been inaccurately reported in the Daily Mail (which seems to enjoy making it readers as anxious as possible) as a state sponsored way of killing the old.
Glyn Davies MP, who sponsored the debate, criticised such poorly informed criticism, without naming the Daily Mail, as shouting ‘Fire’ in a crowded theatre, and said that to abandon the LCP was like “tearing up the Highway Code because there were some bad drivers.”
Sir Tony Baldry MP also spoke sensibly when he said that the NHS wasn’t failing because people died, but failed when they didn’t die well. He stressed the need for improvements in the way medical professionals communicated with dying patients and their families.
Credit must also go to the Shadow Health Secretary Liz Kendall who didn’t oppose this welcome development to the management of end of life but pointed out the LCP was only as good as the teams that used it.
The debate ended with the Health Minister Norman Lamb stating the government’s aim to make all patients’ end of life care as pain free and dignified as possible, and that it was totally unacceptable that patients were put on the Pathway without any notification of the patient’s family.
A vital and as yet overlooked concomitant to the Liverpool Care Pathway is the benefits of the terminally ill and ailing elderly having their own personal death plan, rather as mum’s-to-be have birth plans. Death, after all, is as inevitable as birth.
Filling in a death plan means that the end of life has to be discussed, rather than ignored because it’s awkward, upsetting or embarrassing. And the discussion will inevitably include loved ones, medical professionals and, if appropriate, ministers of religion.
Most importantly, an individual’s death plan will be a properly communicated record which doctors and others involved will, if appropriate, follow so that the patient’s death is as comfortable and comforting as possible. Even if some of the end of life wishes expressed in the death plan are unrealistic, at least the creation of the plan facilitates discussion between the patient, the patient’s family and the those providing the end of life medical care.
My Last Song has created a holistic death plan template which not only addresses medical issues but also other aspects which affect the quality of the end of life experience, such as who the patient wishes to be present, where they want to die, the music they want to hear, the aromas they want to smell, pictures they want to see and also practical matters so they don’t worry about, as an example, who will look after their pets.
We hope the government will suggest the adoption of personal end of life death plans and acknowledges that a good death is more than just good medical care.