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USEFUL RESOURCES
This resource is aimed at professionals working across the palliative care sector and in migrant centres and related organisations.
(more…)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.
An opportunity to better end of life care for older people
Report by Caroline Nicholson and Heather Richardson
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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.
Downloads
Anticipatory Prescribing Guidance for Frail Elderly Patients (PDF) Anticipatory Prescribing Guidance for Adults (PDF) Pan London Symptom Control Medication Authorisation and Administration Record (MAAR) (PDF)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.
Telephone or Zoom support, and some in-person support at Queen Mary’s Hospital Sidcup.
Cruse Bereavement Care
Queen Mary’s Hospital B Block
Frognal Avenue
Sidcup
DA14 6LT
https://www.cruse.org.uk
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.
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.
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 Hospice
Guidelines On The Management Of Delirium In Palliative Care Settings (PDF)
At St Christopher’s we do our best to meet your needs by listening to you, your family and your carers.
One way we do this is by asking you to complete a St Christopher’s questionnaire at regular intervals.
This will help us to focus on what is most important to you.
If you would rather not complete it yourself, then a staff member will be happy to complete the form with you or on your behalf when they see you. The questionnaire is designed to help us understand a number of different issues, such as:
- What is important to you and what your goals are for the next short while
- What, if any, symptoms are affecting you
- How you are managing life at present
- What help you might value, including with any practical issues
- What support your family and friends might need
- How you rate your quality of life at the moment.
If you need help to complete the questionnaire, please do not hesitate to ask one of the team. There are no right and wrong answers – it is purely how you feel.
The information in the questionnaire will be added to your local record and it will be shredded once this is done. For more information on how we use your data view our Privacy Policy or read our leaflet Your information: how we use and keep it.
We hope that you will be able to see that using the questionnaire will enable us to tailor our care and support for you as an individual.
If you are able to, please email the completed form to st.christophers@nhs.net.
“How are you?” printable form
You can print this form and fill out by hand.
If you are able to, please scan the completed form and email to st.christophers@nhs.net
How are you printable form (PDF)“How are you?” interactive form
You can complete this form on your computer.
If you are able to, please save and email the completed form to st.christophers@nhs.net
How are you interactive form (PDF)Dementia specific “How are you?” printable form
You can print this form and fill out by hand.
If you are able to, please scan the completed form and email to st.christophers@nhs.net
How are you printable form – specific for those with dementia (PDF)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.
A short guide to doing your lying exercises safely and effectively.
You may also wish to watch our lying exercises film.
This website hosts the PANG Palliative Care Guidelines developed by a collaboration of UK Health organisations. Additional material is provided by Dr Ian Back.
https://book.pallcare.info/
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 kch-tr.br-bromelyintegratedheartfailurenurses@nhs.net and the referral will get processed by the MDT co-ordinator for discussion.
A pressure ulcer is damage that occurs on the surface and underlying tissues of the skin due to the lack of blood and oxygen supply. You may have known them as pressure sores or bedsores, but they are now called pressure ulcers.
Tips for residents, families and care staff to help enable independence.
A short guide to doing your seated exercises safely and effectively.
You may also wish to watch our seated exercises film.
St Christopher’s CARE has partnered with mental health and wellbeing app ShinyMind to create a new End of Life Masterclass that is packed with scientifically backed, bite-size resources to support the wellbeing of hospice staff while also strengthening their ability to provide high-quality care.
The app offers quick, easy-to-use resources — including short videos, audio clips, and interactive tools — covering important topics such as:
- Building confidence
- Managing emotions and setting boundaries
- Having compassionate conversations
- Reflecting on experiences
- Coping with grief and loss
Find out more about the collaboration.
A short guide to doing your standing exercises safely and effectively.
You may also wish to watch our standing exercises film.
This leaflet contains tips for you, your family, carers and healthcare staff to help enable independence
This leaflet offers advice about which services are best to contact in different situations.
We collect a lot of personal information from and about you, your family and from other services. We need this information so that we can provide you with highest quality care and treatment.
