Tips

• Register the death. You will need to make an appointment at your local register office within five days (eight in Scotland). They will produce a death certificate. Buy a few copies, and take a friend or family member with you for moral support.
  
• Use the ‘Tell Us Once’ Service, your Registrar will be able to give you contact information. This service notifies all the relevant government departments. You can also use the Stop Mail service (see contact details below) who will be able to prevent marketing letters arriving for the person who has died.
  
• You may be entitled to bereavement benefits. Visit the government’s website (below) for more information.

• Arrange the funeral. Under the current restrictions enforced by the Government during the Covid-19 outbreak, funerals and cremations may be disrupted or delayed. If you are using a funeral director, they will be able to explain the current rules. In addition, the number of family members permitted to attend a funeral has been limited, and you may be unable to attend if you are in isolation, which can be very distressing. You might like to think of other ways that you can mark your own private goodbye or memorial at home.

• Some people find it helpful to make a list of family/friends who could give practical help or advice, or to accept support already offered. Tackle things at your own pace and in your own time according to what works for you.

For further help, see

• https://www.gov.uk/when-someone-dies
• https://www.thegoodgrieftrust.org/need-know-info/from-us-to-you/what-to-do-when-someone-dies/
• https://stopmail.co.uk
• https://www.cruse.org.uk/coronavirus/funerals

Leaflet

This leaflet contains further information on your medicines and the way that we sometimes use them in palliative care. If you have any more questions please ask your doctor, nurse or pharmacist. (more…)

• View leaflet

Videos

This audio-visual resource was developed at the request of NHS nurse educators tasked with supporting and integrating newly appointed international nurse recruits.

• Watch video
• https://www.youtube.com/watch?v=KKHqOXDgX5c&feature=youtu.be

Guidance

• https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/880274/Admission_and_Care_of_Residents_during_COVID-19_Incident_in_a_Care_Home.pdf

Documents

Advance Care Planning is a process of discussion between an individual and their care provider. Wishes and preferences are documented in an Advance Care Plan booklet which becomes a patient held record. This has been designed to be provided in the hard copy format which you can obtain from St Christopher’s bookshop. Please do not print from the website. Thank you.

Leaflet

This leaflet explains how to consider your choices and preferences for the future – if you have any other questions, we hope you will talk them over with a member of staff who will be glad to help.
(more…)

• View leaflet

Guidance

This framework has been designed to support GPs to have advance care planning conversations
with patients by phone or video, in the context of COVID-19. It is a tool to help you have honest
and open conversations.

• https://compassionindying.org.uk/wp-content/uploads/2020/04/ACP-conversations-via-Phone-or-Video-Call-v1.pdf

Helpline

If you need any advice or support during this time, please call us on 020 8768 4582

publications

An opportunity to better end of life care for older people

Report by Caroline Nicholson and Heather Richardson

“This document is a “call to arms” to the Hospice movement to recognise that there are a large group of people who currently are denied palliative care…This is a very timely publication. The challenge to us all is to reflect and then act to improve care for our frail older patients.”

Dr Eileen Burns
President of the British Geriatric Society, Consultant in Older People’s Medicine

Guidance

Anticipatory prescribing refers to charts and, where appropriate, medications that are left in a person’s usual place of residence for use by visiting clinicians should problems arise with uncontrolled symptoms.

• Patients are most vulnerable to these in the last days of life and when they are no longer able to swallow
• The common ones are pain, nausea and vomiting, distress and agitation and respiratory secretions
• The guidance below covers these.

There has been controversy over the best practice for clinicians to adopt following the widely publicised Gosport Enquiry.

• General, national guidance and policies are currently under development and several members of the clinical team at St Christopher’s are closely involved with this work
• Our current guidance reflects the developing thinking, is subject to regular review and scrutiny and will be modified as further evidence emerges around the best and safest practice to adopt
• Our 24 hour specialist advice and support is there to back up this general guidance to ensure, as far as possible, that clinical decisions are individualised and safe.

DOWNLOAD ANTICIPATORY PRESCRIBING GUIDANCE FOR FRAIL ELDERLY PATIENTS (PDF)
DOWNLOAD ANTICIPATORY PRESCRIBING GUIDANCE FOR ADULTS (PDF)

Articles

Nursing Times article advising clinicians not to use the Clinical Frailty Scale (CFS) when assessing whether people with learning disabilities and other conditions should be admitted to critical care. 

• https://www.nursingtimes.net/news/policies-and-guidance/avoid-frailty-score-in-covid-19-guidance-when-assessing-ld-patients-24-03-2020/

Leaflet

Most people will experience bereavement at some time in their life. Everyone reacts to their loss in their own unique way

Grief can be very painful and may give rise to feelings and thoughts that you don’t expect. You may find the information in this leaflet helpful. (more…)

• View leaflet

Leaflet

This leaflet will provide you with basic advice to help you manage your breathlessness. It is intended to act as a reminder following a physiotherapy session – please ask if you have any questions. (more…)

• View leaflet

Leaflet

Parents and carers want to do the best for their children, and it is very hard to know what is best for them when a death has happened. You are trying to come to terms with what has happened, cope with painful and difficult feelings, and there are so many decisions and choices to be made.

This leaflet has been written to help you think about your children and the funeral, why they should have the chance to go, and how to answer some of their questions.

(more…)

• View leaflet

Leaflet

St Christopher’s has been providing bereavement counselling to patients’ families for over 50 years. St Christopher’s Candle Child Bereavement Service extends this support to all children, young people and their families in the south east London area, covering the boroughs of Croydon, Bromley, Lewisham, Southwark and Lambeth. Any parent, carer, teacher or healthcare professional can make a referral to the Candle Child Bereavement Service. Young people aged over 16 can refer themselves.

We also offer a specialist training, advice and consultancy service to schools and other agencies working with children facing bereavement.

(more…)

• View leaflet

Leaflet

How to help your bereaved child

You may be bereaved yourself, and may be finding it hard to keep your child’s needs in mind with all that is happening.The following points are a guide to help you focus on what is going on for them. (more…)

• View leaflet

Leaflet

How to help a bereaved young person – a guide for adults

Every year many young people experience the death of someone they are close to. Some of these deaths will be sudden and some will be after a long illness, but all losses can be difficult for teenagers. This leaflet is designed to help you understand some of the aspects of a death that are hard for young people and to give some ideas about how you can offer support. (more…)

• View leaflet

Leaflet

Helping your child

Everyone is very shocked when someone dies suddenly. There has been no time to prepare and often no warning that the person was going to die. Shock affects adults and children physically and emotionally, and some of the effects you may notice are feeling dizzy or sick, shaky, shivery, hot and cold. After a shock we often feel very unsafe for a while, and need to take things quietly. This leaflet mentions some of the things you and your child may be feeling. (more…)

• View leaflet

Guidance

NHS Clinical Guide for Management of Palliative Care in Hospitals during the coronavirus pandemic

• https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0081-Speciality-guide-Palliative-care-and-coronavirus-FINAL-02.04.20.pdf

Guidance

A guide to end of life care symptom control when a person is dying from Covid-19 for General Practice Teams, prepared by the Royal College of General Practitioners and the Association for Palliative Medicine.

• https://elearning.rcgp.org.uk/pluginfile.php/149457/mod_page/content/22/COVID%20Community%20symptom%20control%20and%20end%20of%20life%20care%20for%20General%20Practice%20FINAL%20v2.docx.pdf

Helpline

We have had several requests from Care Homes asking if we can offer support to individual staff. This is why we have created a new staff support service called Hear For You.

What is Hear For You?

Hear For You offers confidential telephone and email support to all care home staff. It is provided by experienced staff and counsellors here at St Christopher’s. Think of this as a ‘check in’ service to support your wellbeing. You may want to talk about a difficult moment at work, worries about your family or friends or simply offload for a few minutes. Whatever you need we’ll do our best to support you – your emotional wellbeing is very important to us.

How do I access support?

Simply email us at hearforyou@stchristophers.org.uk or call us on 020 8768 4688. Let us know which CCG you work in, and where possible the care home you work for. This will remain completely confidential. We will be available between 9am and 5pm, Monday to Friday. If you want to book in a call outside of these times simply email us and we’ll do our best to fit this in for you.

Is this support confidential?

Please rest assured that everything you share will remain confidential unless we have a concern that falls within our safeguarding protocol.

Documents

Documents

Documents

Guidance

Coordinate My Care is an innovative NHS service that builds medical care around the wishes of each patient. You create the plan with your GP: then we share it with all the healthcare professionals who might treat you. So everyone looking after you knows exactly what you want.

• https://www.coordinatemycare.co.uk/

Guidance

Quick Reference Guide to CMC Urgent Care Plans

• https://coordinatemycare.co.uk/wp-content/uploads/2018/12/cmc-quick-reference-guide.pdf

Leaflet

This leaflet describes some of the physical changes that happen to people as they start to die. It anticipates some of the questions you may want to ask about what is happening and why, and encourages you to ask for further help or information if there is anything at all that is worrying you.
(more…)

• View leaflet

Leaflet

1 Coping with feelings of depression

There is no right or wrong way to feel when you or someone close to you has a terminal illness. You may experience a range of emotions, at different times. You may feel shock, fear, anger and resentment. Or you may feel helpless, sad, frustrated or perhaps experience relief and acceptance. You may also feel isolated and alone, even if you have family and friends around you.
(more…)

• View leaflet

Guidance

Guidance for health and social care staff who are caring for, or treating, a person who lacks the relevant mental capacity.

• https://www.gov.uk/government/publications/coronavirus-covid-19-looking-after-people-who-lack-mental-capacity

Virtual learning

This programme is freely available to colleagues working in the NHS, independent sector and social care.

• https://www.e-lfh.org.uk/programmes/coronavirus/

Weblinks and Resource Lists

The Royal College of GP’s coronavirus resource hub which includes a palliative care section

• https://elearning.rcgp.org.uk/mod/page/view.php?id=10537

Weblinks and Resource Lists

Learning Disability Wales guidance resources for Covid-19 

• https://www.ldw.org.uk/project/coronavirus/https://www.ldw.org.uk/project/coronavirus/

Weblinks and Resource Lists

Carers in Southampton, Covid 19 learning disability resources

• https://www.carersinsouthampton.co.uk/covid-19-learning-disability-resources

Guidance

National Institute for Health and Care Excellence, Covid 19 Guidance on supporting staff who are self-isolating, communicating with patients, remote working and reviewing and stopping critical care treatment 

• https://www.nice.org.uk/guidance/ng159

Community palliative, end of life and bereavement care in the Covid-19 pandemic

A guide to end of life care symptom control when a person is dying from Covid-19 for General Practice Teams, prepared by the Royal College of General Practitioners and the Association for Palliative Medicine.

• https://elearning.rcgp.org.uk/pluginfile.php/149457/mod_page/content/22/COVID%20Community%20symptom%20control%20and%20end%20of%20life%20care%20for%20General%20Practice%20FINAL%20v2.docx.pdf

Guidance

Royal College of Psychiatrists, Community and inpatient services – COVID-19 guidance for clinicians

• https://www.rcpsych.ac.uk/about-us/responding-to-covid-19/responding-to-covid-19-guidance-for-clinicians/community-and-inpatient-services-covid-19-guidance-for-clinicians

Guidance

• https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/880094/PHE_11651_COVID-19_How_to_work_safely_in_care_homes.pdf

Guidance

Guidance

The aim of this guidance is to support clinicians and others in considering the needs of and providing high quality care for frail older people as they move towards the end of their lives. 

• https://www.bgs.org.uk/resources/resource-series/end-of-life-care-in-frailty

Articles

End of Life Journal was a free, online, peer-reviewed journal that published articles on all aspects of nursing practice relating to end-of-life care.

The journal was primarily aimed at generalist nurses working in hospital, community and care home settings. Many articles will also be of interest to the palliative care nursing audience as well as members of the wider multidisciplinary team.

The journal focused on care for patients with both malignant and non-malignant disease and their family and friends.

• https://www.stchristophers.org.uk/end-of-life-journal/

Training

Our End of Life Care webinar series launched April 16 and is free to all care homes. In this three-part weekly series, we share our expertise in practices such as Advance Care Planning, Coordinate my Care (myCMC), and Challenging Conversations – covering the important aspects of communications around death and dying during Covid-19.

• https://www.stchristophers.org.uk/stc_education_event/virtual-learning/

Leaflet

When you are referred to our services, one of the questions we will ask you is about your ‘next of kin’. This is a term that most people have come across without knowing exactly what it means. This leaflet aims to explain it. (more…)

• View leaflet

Documents

Videos

Alternative video (no introduction):

• Watch video

Guidance

HEE guidance: In light of the COVID-19 pandemic, HEE, Skills for Care and the Department of Health and Social Care have decided to extend the deadline for tenders for trial and evaluation partners for the Oliver McGowan Mandatory Training to 24 April at 18:00. This was communicated on 18 March, to those who had expressed an interest in bidding. The delay of one month extends the time existing bidders have left to submit from 7 to 26 working days

• https://www.hee.nhs.uk/our-work/learning-disability

Leaflet

Is it normal to feel this way?

When someone who is important to us dies it can feel unbearable, as though our whole world has changed. As unique individuals, our response to loss is also likely to be unique, and can be affected by the relationship we had with the person who died. There is no right or wrong way to grieve. (more…)

• View leaflet

Weblinks and Resource Lists

Personal protective equipment (PPE), environmental decontamination, clinical waste and aerosol generating procedures.

• https://www.england.nhs.uk/coronavirus/primary-care/infection-control/

Weblinks and Resource Lists

Documents

Leaflets

St Christopher’s has produced a range of information leaflets for patients and carers. Healthcare professionals and other organisations may use this material providing St Christopher’s is credited as author. Copyright remains with St Christopher’s Hospice. For further information regarding use of leaflet material, please contact the Communications Manager on tel: 020 8768 4585 or email: communications@stchristophers.org.uk

• http://www.stchristophers.org.uk/patients/leaflets

Weblinks and Resource Lists

A range of resources and printable materials from Oxford Health NHS

• https://www.oxfordhealth.nhs.uk/learning-disability-service/useful-stuff/

Guidance

National Association of Psychiatric Intensive Care guidance on supporting patients presenting acute disturbance

• https://napicu.org.uk/wp-content/uploads/2020/03/NAPICU-Guidance_rev1-1.pdf

Videos

A lesson for all health and care workers in measuring the blood pressure of a patient in relation to National Early Warning Score (NEWS)

• Watch video
• https://youtu.be/G8QkaAyqatE

Videos

This video shows you how to check your blood glucose level.

• Watch video
• https://youtu.be/jg5cl2P3RRA

Weblinks and Resource Lists

NHS A to Z list of medicines

• https://www.nhs.uk/medicines/

Videos

From the book Postcards from Heaven, words and pictures to help you hear from God, but Ellie Hart.

• Watch video

Videos

(more…)

• Watch video

Guidance

Mental Capacity Assessment

• https://www.scie.org.uk/care-providers/coronavirus-covid-19/mca

Videos

Take a break from your desk to enjoy this short video on mindful breathing led by Sarah.

• Watch video

Webinar

Stirling Moorey is a Consultant Psychiatrist in CBT, South London and Maudsley NHS Trust and Visiting Senior Lecturer Institute of Psychiatry, Psychology and Neuroscience. Stirling provides weekly mindfulness sessions. To be included in the notifications for these sessions, please email Stirling on Stirling.Moorey@slam.nhs.uk

Guidance

This guide is for people who are approaching the end of their life. Some parts of it may also be useful for people who are caring for someone who is dying, or people who want to plan in advance for their own end of life care.

• https://www.nhs.uk/conditions/end-of-life-care/?tabname=planning-ahead

Helpline

The NHS have introduced a confidential staff support line, operated by the Samaritans and free to access from 7:00am – 11:00pm, seven days a week.

• https://people.nhs.uk/help/

Videos

• Watch video
• https://www.youtube.com/watch?v=QabKghrtXps

Leaflet

A funeral is a significant event. It may not be easy to think about, whether your own or that of a relative; for example how best to commemorate a life, what to include or leave out. However, planning a funeral can be helpful for those who are approaching the end of life and is one way of ensuring that their wishes are respected. (more…)

• View leaflet

Documents

Videos

YouTube video – Infection prevention control guidance to staff – Donning and Doffing

• Watch video
• https://www.youtube.com/watch?v=JEnuKKY04Bc&feature=youtu.be

Webinar

Important information: Both the Webinar and Q&A session were presented on 1 June 2021 by Lelly Oboh and Bethan Warner. All content was accurate at the time.

Q&A

Downloads

The webinar is presented by Bethan Warner, Integrated Care Pharmacist – Care Homes and Lelly Oboh Consultant Pharmacist, Care of Older People Guy’s & St Thomas’ NHS Foundation Trust.

Presented by

Bethan Warner Integrated Care Pharmacist

Bethan Warner is Care Home Pharmacy team lead pharmacist for Integrated Care, Guy’s & St Thomas’ NHS Trust.

The team work with nursing homes in Lambeth and Southwark, delivering person-centred medicines reviews for the residents and providing “Care Home centred care” to support the care homes with their medicines processes.

Lelly Oboh Consultant Pharmacist

Lelly Oboh is a Consultant Pharmacist (care of older people) with considerable experience working within general practice, care homes and integrated care teams in the community to optimise medicines use .

Her leadership role involves championing innovative pharmacy service developments, showcasing and driving uptake at local and national levels.

Her areas of interest include patient centred care, deprescribing, frailty, care co-ordination, transfer of care, medicines use in care homes and social care settings.

• Watch video

Documents

Documents

This new resource aims to support you to acknowledge the losses you, your colleagues and the people you support are experiencing during the Covid – 19 Pandemic. We believe Activity and Care teams can play a vital role in coordinating essential activity related to saying goodbye.

Contributors include Sarah Guyan from St Christopher’s Hospice.

• https://napa-activities.co.uk/wp-content/uploads/2020/10/Saying-Goodbye-A-Resource-for-Care-Homes.pdf

Articles, publications

Library

The Halley Stewart Library at St Christopher’s Hospice comprises an extensive collection of resources, mainly books, journal articles and various types of unpublished printed material, on hospice and specialist palliative care and allied subjects. Various publications, available from the Bookshop and Library, give a full account of the history of this hospice and of its founder Dame Cicely Saunders.

FIND OUT MORE ABOUT ST CHRISTOPHER’S HOSPICE LIBRARY

Bookshop

The Bookshop at St Christopher’s comprises a core collection of books and articles on hospice and palliative care. Publications by St Christopher’s staff are also available from the Bookshop.

VIEW ALL BOOKSHOP CATEGORIES

Guidance

Managing acute disturbance in the context of COVID-19

• https://napicu.org.uk/wp-content/uploads/2020/03/NAPICU-Guidance_rev1-1.pdf

Videos

A visual lesson for all health and care workers in measuring the temperature of a patient

• Watch video
• https://www.youtube.com/watch?v=UxE6J9YBxqs

Guidance

This guide shares lessons for civil society and public sector organisations on how to design and deliver social action programmes that are more age-inclusive and age-friendly. It outlines some of the tactics and practical approaches that worked well for the innovations NESTA have backed.

• https://media.nesta.org.uk/documents/The_Age_of_Inclusion_zEtwIhJ.pdf

Videos

Presented by Dr Victor Pace, Consultant in Palliative Medicine, Greenwich & Bexley Community Hospice and Darent Valley Hospital.

This presentation was recorded on 29 March 2020.

Download transcript (PDF)

• Watch video

Videos

The Hand Washing Rap video made with Purple All Stars 

• https://vimeo.com/134952598

Documents

Training

St Christopher’s has developed an online version of our Verification of Expected Adult Death course for registered nurses to support the urgent need for expertise in this area during this time.