Showing posts with label Liverpool Care Pathway. Show all posts
Showing posts with label Liverpool Care Pathway. Show all posts

TIME TO SAY GOODBYE

My uncle passed away suddenly four weeks before Mom succumbed to her cancer. He was not unwell and had been watching the Springboks lose to the All Blacks. He suffered a massive heart attack which was complicated by a weakened aortic wall. Despite extensive surgery, over a number of hours, the surgeons could not save his life. He died without saying his final goodbyes to his assembled family. His daughters are my age and I felt so desperately sad for their loss. They never had time to say goodbye.

I know that Mom hated her illness and was so frightened of her diagnosis. But as the months went on and Mom came to accept her situation, I felt so privileged to have the time together. Of course, nothing can ease the pain of bereavement but Mom's death was uncomplicated and peaceful, at home. We had said everything we needed to say.

Two important things helped us. One, Mom's GP and District Nurse helped Mom to sign a Do Not Resuscitate order. This meant that if the paramedics were called to the house, they would know that Mom didn't want to die in hospital and did not want any resuscitation or intervention. And two, as Mom's death approached the nurses took Dad and I through the Liverpool Care Pathway. We sat calmly with a cup of coffee, away from Mom as she was semi-conscious but could still hear. This topic was covered by Danny Pike on BBC Surrey today.

The pathway is designed to make sure that the family understands what is about to happen and to bring in any other support that may be required. It was very comforting and positive, and we were prepared when Mom stopped breathing. Afterwards, it was so quiet. We had no more words, nor did we need any.


...IT IS NOW

Mom died on 27 August 2011. 

After the chemotherapy was abandoned in July, Mom had a course of radiotherapy to treat a tumour on her spine and underwent pleurodesis to stop her drowning in fluid around her lungs. To those of us who helped Mom every day, we knew that the tingling in her legs wasn't a good sign, and the tumours in her lungs were producing so much fluid that Mom's right lung was squashed in her chest. These two interventions made Mom comfortable and pain-free. We talked about dying and Mom decided to die at home. 

The wonderful community health team provided a profile bed, commode, and daily personal care. They implemented a plan for making sure that Mom had a dignified death in the community with a do not resuscitate order preventing any last minute heroic interventions by paramedics.

Mom stopped eating on the Friday and was semi-conscious on Saturday. The Community Nurse took us through the Liverpool Care Pathway, a model for end-of-life care. I took the dogs to her to say goodbye and then Dad stayed with her. She just took a last breath and that was that.