The inevitability of us all arriving at a point in our lives when our bodies succumb to age and/or illness is one we accept but rarely address until we have to face it. During those last stages of life our role as GPs is to guide, inform and accompany. Often there is a gap between a patient receiving a terminal diagnosis in hospital and entering the last stages of illness at home. This can be a difficult and unpredictable stage, filled with questions and uncertainties. To help patients during this period Jan Hebditch has returned to work for us as a special Palliative Care liaison nurse. Lots of our patients will know Jan from her many years leading our superb District Nursing team. Her clinical skills, knowledge, experience and contacts within the local healthcare system are second to none. Jan’s role is unique to Wyndham House; we have specifically designed it to fill a gap that exists in the current NHS service. We are incredibly lucky to have Jan re-join us and we owe an enormous thank you to the Friends of Wyndham House for funding this very bespoke role.
Expectation and understanding of what happens as a disease progresses is essential to helping patients and their families. It is important to remember that there are no ‘musts’ in terminal care apart from a patient passing away pain free and peacefully. Choices about this are very personal. Passing away at home is not everyone’s wish; for some it might be very important, for others it is something they may strongly want to avoid. It is absolutely fine to change your mind mid-journey. Patients and their families need time and space to talk about what they feel most comfortable with. We can adapt to all needs and one of Jan’s roles will be to facilitate this when the time is right.
Whilst death is always accompanied by sadness of the loss, the process should be as smooth and supportive as possible. Good communication between everyone involved is key and as a surgery we continually strive to maximise this as much as we can. As individuals we have little power over the nature and speed of our last illness but as carers we can ensure our patients and their relatives have as much control as possible to fulfil their end of life choices with dignity.
Dr Anthony O’Brien
Wyndham House Surgery