This booklet will guide you through a series of questions and ideas for you to think about. The booklet is yours and you can show it to whoever you decide needs to see it. Just ask your nurse if you would like one or download and print it off below. If you have any other questions, we hope you will talk them over with a member of staff who will be glad to help.
If you need advice or support please call us on 02087684582
Your call and brief details will be taken by a member of our admin team and forwarded to the appropriate team. A member of the team will ring you back on the same day. Please leave a number that we can easily contact you on.
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.
DownloadsAnticipatory Prescribing Guidance for Frail Elderly Patients (PDF) Anticipatory Prescribing Guidance for Adults (PDF) Pan London Symptom Control Medication Authorisation and Administration Record (MAAR) (PDF)
Answers, advice and support from the Rowland Brothershttps://rowlandbrothers.com/arranging-a-funeral/bereavement-support/
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.
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.
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.
Decision-making tool and prescribing guidanceDownload
Age UK is the leading charity for older people. Visit Age UK for help, information and advice.https://www.which.co.uk/later-life-care/end-of-life/coping-with-bereavement
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.
Nationwide Bereavement Support
Cruse provides support services for people across the UK who have been bereaved. The helpline offers listening support and practical advice related to bereavement, including dealing with an estate, debt and arranging a funeral.0808 808 1677
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/
When a patient is nearing the end of their life, health care professionals should be aware of those who have internal cardiac defibrillators and should be considering deactivation in a timely manner to prevent inappropriate shocks at the end of someone’s life, which are painful and distressing for the individual and those close to them.
Palliative care can help with starting these conversations and coordinating the process. If someone is too unwell to attend the hospital for formal deactivation we have magnets available to take out for those who are dying and have an active device.
If you have a patient with an active internal defibrillator ( either an ICD or a CRT-D) in situ and you are concerned they are approaching end of life- please consider referring to palliative care for support with conversations around deactivation. If the patient has a Bromley or Croydon GP please consider referral to the Palliative heart failure service at St Christopher’s. Please see the guidance that we follow and if you have questions or are unsure whether to refer someone please call the hospice for advice.Guidelines for deactivating implantable cardioverter defibrillators (ICDs) in people nearing the end of their life
From St Christopher’s HospiceGuidelines On The Management Of Delirium In Palliative Care Settings (PDF)
Cruse provide a helpline and other support for young people aged 12-18 following a bereavement.
Are you caring for someone who has a terminal illness or is nearing the end of their life? St Christopher’s Hospice provides the Lewisham Carer Telephone Support Service for Lewisham residents. This telephone support service can assess your needs and help you in your caring role.
The Living Well at Home Team consists of therapists and volunteers working towards your goals with you in your own home. They can support you to try to improve your mobility, cope with breathlessness or fatigue, avoid falls, or enable you to better manage your activities of daily living.
GPs in Bromley can refer into the monthly palliative heart failure MDM if they’re uncertain about a patient’s diagnosis and whether there is a need for sub cut furosemide to help direct correct treatment.
Email firstname.lastname@example.org and the referral will get processed by the MDT co-ordinator for discussion.
If you have recently been bereaved by suicide, the South East London Suicide Bereavement Service is here to provide support from both a practical and an emotional perspective. The staff team includes Suicide Bereavement Support Workers, Community Chaplains and a Bereavement Counsellor.https://blgmind.org.uk/bromley-mental-health/suicide-bereavement-support/
Tell Us Once is a service that lets you report a death to most government organisations in one gohttps://www.gov.uk/after-a-death/organisations-you-need-to-contact-and-tell-us-once
A Low cost counselling agency.
Greenwich-based charity that promotes emotional health and wellbeing, and offers a range of therapeutic services.
Winston’s Wish delivers support services to children who have been bereaved in the UK. As well as in-depth therapeutic help in individual, group and residential settings, they run a national helpline and have resources for children to help them through their bereavement.https://www.winstonswish.org/