Guest post by Richard Meade, Head of Policy and Public Affairs, Marie Curie
When someone becomes terminally ill or are coming to the end of their lives there are many things for them, their family and friends to think about. It can be a very difficult time with lots of tough choices to be made. For many, where a person spends their time and receives their care is an incredibly important part of those plans.
People living with a terminal illness generally want to be at home for as much as possible, including getting their care there and many would prefer to die at home too. For some people their home can be a care home or nursing home and this is important to understand too.
At the moment far too many people at the end of life are spending too much time away from their home. Currently people in the last six months of life spend anywhere between 10 and 22 days in hospital. We also know that 30% of people in hospital are in the last 12months of life, and that 50% of all deaths are in a hospital.
Things can certainly be improved.
The recently launched Scottish Government’s national conversation and focus on the future of health and social care is welcome.
This conversation must centre on what matters to people. For example, ensuring that everyone living with a terminal illness or approaching the end of life has a detailed plan setting out their wishes and needs is essential. This plan must be well supported, shared around all those involved in delivering that care, and properly resourced with 24/7 services, where required. It must be flexible to changing needs and where hospital admissions are necessary, the system must ensure that a person receives the care that they need and are discharged back home or to the community, as quickly and safely as possible.
The focus of the conversation must not be confined to the statutory sector. Health and social care is increasingly delivered by a multitude of people and organisations both formally and informally. This can include third sector organisations, such as Marie Curie, as well as the person’s family, friends and neighbours who may take on caring roles. It can include other community resources too all of which can help keep someone at home or in the community.
These resources must be utilised and centred on the wishes and needs of the person in receipt of them. For someone living with a terminal illness, where care can become very complex and demanding, this is vital.
When time becomes short, supporting and sustaining someone’s wellbeing and quality of life can become increasingly challenging, but never more important. This should be at the very heart of our national conversation and the centre of our vision for care by 2030.
Head of Policy and Public Affairs, Scotland