Palliative Care

Dr Crippen posted yesterday on palliative care.

What is palliative care? Care for those who are dying - slowly. Faster or slower - it doesn't much matter as they are still in pain, need pain control drugs, need their incontinence cleaned up, need the bedsheets changed etc etc.

Most palliative care is for older people as their bodies begin to fail. Their partners and carers are of similar age and find it hard to cope. But there are also many middle-aged, young adults or children.

There are some government-funded NHS palliative care "hospices" around the country ... but not many. Dr Crippen informs me that most of the slowly-dying patients with no hope left are left in a geriatric ward at a hospital in the furthest bed from the nurses' desk in the ward (so they can't smell the shit).

The government has just announced it wants to encourage you to die in the comfort of your own home amongst your loved ones. Dr Crippen approves - if your 80 year-old spouse can cope with this, your GP, District Nurse, social worker etc can provide you with the support you need.

But the NHS cannot provide you with the support you need.

Encouraging us to die at home rather than in an under-funded and scarce resource is not, as Dr Crippen notes, a measure of government sympathy for those dying but another cynical attempt to cut NHS funding - in this case on hospital-beds, hospice space and resulting staffing etc

A.'s middle-aged active husband died of cancer at the same time as her 17 year-old daughter H. is going through leukaemia. A. now has no husband, three children and has to take her oldest child to hospital 50 miles away ...

So I will question the palliative hospice system (in the UK) - is a hospice for Kezia (4 years-old and alive and doing well), Lucia (17 years-old alive and doing well), Adrian Sudbury (27 years-old dying), Christian Jago (middle-aged and dead) etc etc going to have the same needs as that of the 60/70/80+ year old? Will there be a paedatric/adult/geriatric palliative care doctor/nurse? I doubt.

Christian and Colin Jago had to move from their idyllic home in NW Scotland into a grubby inner-city Aberdeen flat, and soon afterwards Christian had to move into a hospice to die soon afterwards ...

Update: article in the US Candlighters journal on palliative care for children.