SOURCE: St Christopher's | TYPE: 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

SOURCE: St Christopher's | TYPE: Tips

• Think about your future care and support. A good place to start could be to think, ‘what’s important to me’? For example, would you choose to be at a hospice or stay at home; who would you like to be there if you get sick, and what kinds of treatments would you like or refuse? Write your decisions down so that those who care for you have a record.

• Plan your own funeral: it isn’t being morbid, it’s being organised. Decide how you’d like it, then let your family know. When the time comes, it will be a huge comfort to them to know they are doing the right thing. You may want to talk with your family about how a funeral will be paid for and what aspects of the funeral are most important to you.
  
• Make your thoughts about organ donation known and record them, so that your loved ones know your wishes in advance.

• Consider whether you need to make a Will, which can allow you to plan what happens to you money, dependents, and possessions after you die. Making your wishes known in advance through a Will can often help to give you peace of mind for the future.

• Think about your digital legacy, for example, what would happen to the information on your mobile phone or Facebook account. Take time to understand the options and then let people know what you’d like to happen.

For further information see https://www.dyingmatters.org/page/planning-ahead and St Christopher’s Leaflet on Do I need to make a Will?

SOURCE: St Christopher's | TYPE: Tips

• Be honest and personal: it’s OK to say ‘I know this is a sensitive subject’, or ‘we’ve never spoken about his before, but’ and then explain why it’s important to you to talk about dying and death
  
• Choose your moment and try a general question like ‘have you ever thought about what you’d like to happen if you became seriously ill?’ or ‘have you ever thought about what kind of funeral you’d like?’ Or you might ask if they’ve considered what would happen to any dependents, organ donation, things that they’d like people to know, or written a Will  
  
• If at first you don’t succeed… Try again later. You may have caught your loved one on an off day – but at least you’ve started the conversation
  
• Mind your (body) language: non-verbal clues like crossing arms or covering their mouth may be a sign this conversation is uncomfortable. And watch your own body language too! Remember to relax and smile
  
• Listen more than you speak. Once you’ve asked the initial question, concentrate on their answer. You may be surprised at what you hear and it could be a relief for the other person to talk openly.

For further help, go to https://www.dyingmatters.org/page/TalkingAboutDeathDying

SOURCE: St Christopher's | TYPE: Tips

• Distract yourself a little if you can. Have a cuppa with a friend, if it’s possible, or watch a film
• Being outdoors around nature is often beneficial for your mental wellbeing
• Find a healthy outlet to express your grief – through exercise, talking, journaling or painting
• Let others know what support or help you need, be it practical or emotional support
• Promise yourself you won’t feel guilty if you laugh or forget for a moment that you are grieving. Instead, be grateful for these brief moments of respite.

For further help in your bereavement, go to

• https://www.stchristophers.org.uk/leaflets/help-during-your-bereavement
• https://www.thegoodgrieftrust.org/

SOURCE: St Christopher's | TYPE: Tips

• It is very difficult to make sense of a death, sudden or expected. We are unable to make meaning of it for some time. We need to find ways in place of the previously recognised opportunities to gather and remember in the days after a death.

• What rituals have been traditional in your family around a funeral or afterwards? Think how you might use these at home. Are there prayers or poems or prose or music that has a particular resonance and importance to you, or to the person who has died?

• For the funeral, ask if it is possible to livestream the event so that family and friends can join this remotely.

• Plan an event in the future when you can gather as a family with friends. What would be appropriate? Sharing stories, planning a eulogy or tribute, creating a photo montage.

• Take time to remember alone. If lighting a candle or writing your memories helps with the remembering, these are good ways to hold the person who has died in your thoughts.

For more support you could visit https://www.cruse.org.uk/coronavirus/funerals

SOURCE: St Christopher's | TYPE: Tips

• Not being present when a relative dies, having the opportunity to say ‘goodbye’ or being unable to attend a funeral or memorial service can make grief more complicated to navigate. Saying goodbye matters. Each person must find their own ways to seek, create and take memories which allow the person who has died to remain present in the life of the bereaved even though physically absent.
  
• Sharing stories and memories of the person who has died, either by writing a journal, or a joint phone call, or writing memories down helps to keep the person ‘alive’ in our thoughts.
  
• Find a time in the year when the social situation changes when you can gather together to memorialise. In this, tell your memories, share pictures, allow yourselves to feel the sadness of the occasion as well and the happier memories you have.
  
• It is possible to create memorial pages on social media sites. These can be accessed by several people who have permission from the page ‘owner.’
  
• St Christopher’s has our own memorial pages for those who would like to develop their own away from social media. These allow memories to be written, photos to be added and ‘virtual candles’ to be lit.
  
• The date of a death, a birthday or important anniversary can become occasions when the person who has died is remembered.
  
• Bereavement does not end, it is lived with, and men and women remain bereaved. Enabling personal and shared opportunities to remember and memorialise recognises the we have continuing bonds with the deceased person.

SOURCE: St Christopher's | TYPE: Tips

• It’s better to do something than nothing – to acknowledge loss rather than ignore it
  
• Look for invitations to talk from the other person. If they start talking about the person who has died, encourage them, even if it seems to make them upset
  
• Be comforting when opening up the conversation rather business-like
  
• Try and create an environment where the person has the freedom to talk or not talk, according to what they want. “I’m around all day if you fancy a chat…” 
  
• Grief has its own pace and time so it will be different for each one of us. There should be no expectation on a bereaved person, for instance, that they need to cry – or stop crying – they will find a way through this that’s best for them

Further support can be found at
St Christopher’s Bereavement Team 020 8768 4599, info@stchristophers.org.uk 

Or https://www.thegoodgrieftrust.org/

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: Health Education England | TYPE: Videos

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

SOURCE: Department of Health and Social Care, NHS, Public Health England | TYPE: Guidance

SOURCE: St Christopher's | TYPE: 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.

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: Compassing In Dying | TYPE: 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.

SOURCE: St Christopher's | TYPE: Helpline

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

SOURCE: St Christopher's | TYPE: 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

SOURCE: St Christopher's | TYPE: 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)

SOURCE: Nursing Times | TYPE: 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. 

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: NHS | TYPE: Guidance

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

SOURCE: Association for Palliative Medicine, Royal College of General Practitioners | TYPE: 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.

SOURCE: St Christopher's | TYPE: Telephone

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.

SOURCE: St Christopher's | TYPE: Documents

SOURCE: St Christopher's | TYPE: Documents

SOURCE: St Christopher's | TYPE: Documents

SOURCE: Coordinate My Care (CMC) | TYPE: 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.

SOURCE: Coordinate My Care (CMC) | TYPE: Guidance

Quick Reference Guide to CMC Urgent Care Plans

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: Department of Health and Social Care | TYPE: Guidance

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

SOURCE: NHS | TYPE: Virtual learning

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

SOURCE: Royal College of General Practitioners | TYPE: Weblinks and Resource Lists

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

SOURCE: Learning Disability Wales | TYPE: Weblinks and Resource Lists

Learning Disability Wales guidance resources for Covid-19 

SOURCE: Carers in Southampton | TYPE: Weblinks and Resource Lists

Carers in Southampton, Covid 19 learning disability resources

SOURCE: NICE | TYPE: 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 

SOURCE: Association for Palliative Medicine, Royal College of General Practitioners | TYPE:

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.

SOURCE: Royal College of Psychiatrists | TYPE: Guidance

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

SOURCE: Public Health England | TYPE: Guidance

SOURCE: Department of Health and Social Care | TYPE: Guidance

SOURCE: British Geriatrics Society | TYPE: 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. 

SOURCE: British Medical Journal, St Christopher's | TYPE: 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.

SOURCE: St Christopher's | TYPE: 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.

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: St Christopher's | TYPE: Documents

SOURCE: Health Education England | TYPE: 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

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: NHS | TYPE: Weblinks and Resource Lists

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

SOURCE: St Christopher's | TYPE: Weblinks and Resource Lists

SOURCE: St Christopher's | TYPE: Documents

SOURCE: St Christopher's | TYPE: 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

SOURCE: NHS | TYPE: Weblinks and Resource Lists

A range of resources and printable materials from Oxford Health NHS

SOURCE: National Association of Psychiatric Intensive Care and Low Secure Units | TYPE: Guidance

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

SOURCE: Health Education England | TYPE: 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)

SOURCE: NHS | TYPE: Videos

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

SOURCE: NHS | TYPE: Weblinks and Resource Lists

NHS A to Z list of medicines

SOURCE: St Christopher's | TYPE: Videos

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

SOURCE: St Christopher's | TYPE: Videos

(more…)

SOURCE: Social Care Institute for Excellence | TYPE: Guidance

Mental Capacity Assessment

SOURCE: St Christopher's | TYPE: Videos

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

SOURCE: | TYPE: 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

SOURCE: NHS | TYPE: 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.

SOURCE: NHS | TYPE: Telephone

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.

SOURCE: Health Education England | TYPE: Videos

SOURCE: St Christopher's | TYPE: 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…)

SOURCE: St Christopher's | TYPE: Documents

SOURCE: HywelDdaHealthBoard | TYPE: Videos

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

SOURCE: St Christopher's | TYPE: Documents

SOURCE: National Activity Providers Information | TYPE: 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.

SOURCE: St Christopher's | TYPE: 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

SOURCE: National Association of Psychiatric Intensive Care | TYPE: Guidance

Managing acute disturbance in the context of COVID-19

SOURCE: Health Education England | TYPE: Videos

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

SOURCE: NESTA | TYPE: 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.

SOURCE: St Christopher's | TYPE: 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)

SOURCE: Purple All Stars | TYPE: Videos

The Hand Washing Rap video made with Purple All Stars 

SOURCE: St Christopher's | TYPE: Documents

SOURCE: St Christopher's | TYPE: 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.