#71 Dying at home, what you need to know and how to be prepared - Symptom control and medication as someone approaches the end of life at home
25.09.23
#71 Dying at home, what you need to know and how to be prepared - Symptom control and medication as someone approaches the end of life at home
This is the fourth in a series of seven podcasts about End of Life Care, specifically towards the last days of life and when someone wishes to die at home. Rachel kindly agreed to make these with me and recreate some of the conversations I have had over so many years about dying at home, what you need to know and how to be prepared.
In this episode we talk about symptom control in the last days of life when someone is dying at home.
Dying at home, what you need to know and how to be prepared
1.Recognising when someone might be approaching the last stages of life and why this matter
2. What support is available to help look after a person who is dying at home
3. What equipment might be needed to help look after a person who is dying at home
4. Symptom control and medication as someone approaches the end of life at home
5. What changes are there as someone approaches the end of life?
6. What we need to do after a person has died at home
7. Changing plans, anticipatory grief and being prepared
Key messages from guest
Treatment at the end of life focuses on palliation or control of symptoms
Medication can be rationalised or revised towards the end of life to ensure medication focuses on easing symptoms and removing the burden of taking medications that are no longer needed.
Conversations about stopping or changing medications should happen to explain to clearly explain the reasons
Tests should also be reviewed to consider if they are still appropriate
A syringe pump can be used at a time when a person may no longer be able to swallow tablets
Syringe Pumps can be used for pain, sickness, agitation or breathing symptoms
Medication is only one way of controlling symptoms, it is always appropriate to consider the cause of a symptom and how they may be managed without medication
Some areas have a policy for informal carers to administer medication for symptoms, finad out what happens in your area
Episode takeaways
Morphine does not hasten death when given in appropriate, incremental doses
Syringe pumps do not hasten or cause death when medication is titrated to need
Symptom control should always be personalised
All prescribed medications should be written on a chart for medication administration
Be prepared, think ahead to ensure medications for the end of life are in place
Resource
Read Is end-of-life anticipatory prescribing always enough? By Dr Ben Bowers
Listen to Dr Kathryn Mannix explain Ordinary Dying in episode 32: Using tender conversations in Advance Care Planning with Dr Kathryn Mannix
Access Rachel’s work
Website:The Magnificent Midlife
Podcast: The Magnificent Midlife Podcast
Bio:
Rachel Lankester, founder of Magnificent Midlife
Rachel Lankester is the founder of Magnificent Midlife, an online hub celebrating and empowering women 40+. She's the author of Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond and host of the Magnificent Midlife podcast. After a shocking early menopause diagnosis at 41, she scratched her own itch and created what she wasn't able to find to help herself. This includes 1-1 and group mentoring, courses and educational resources to help women vibrantly transition through the sometimes messy middle of life. She's also the founder of MenoClarity, an online information hub about menopause.
Clare Fuller, Advance Care Planning Advocate, Educator & Coach
Clare is a Registered Nurse with 30 years’ experience in End-of-Life Care (EoLC). Clare is an advocate for Advance Care Planning and founded www.speakforme.co.uk to help organisations to improve EoLC, provide professional education and raise public awareness about Advance Care Planning. Clare campaigns for proactive Advance Care Planning, hosts the podcast Conversations about Advance Care Planning and is a Lasting Power of Attorney Consultant.
Find out more about my Bespoke Consultancy
If you’d like to find out more about my work contact me.
What one thing will you do?
It would be great to share what resonated with you from this episode, what is the one thing you will do differently? Head to Twitter, Facebook or LinkedIn to continue these important conversations.
Thanks to all my guests for working with me to share their knowledge, experience and stories about Advance Care Planning. I hope you enjoyed listening and have insights to take away; I love hearing your reflections on the series and look forward to reviews on Spotify where you can also subscribe to the series.
Clare
Important Conversations about Important Conversations.