Heartbeat: Learning from our experiences to improve end of life care

November 21, 2022

Over the past year the palliative care team have been leading a Trustwide quality improvement project to enhance the care delivered to patients approaching the end of life. This is relevant to colleagues in all specialties and an opportunity to see excellence in care become the consistent norm for our patients, whoever they are and wherever they are looked after.

In this issue of Heartbeat, we feature the story of Dr Paul Turner, a local GP who tells us of his experiences with our teams when his father was in his last days of his life.

Paul said: “Dad was 87 and had been working as a doctor in Africa until a year before he died. His death was a real shock to all of us as he was doing press ups every day until two months before he was admitted to hospital. He was full of life and had just re-married, so he had a lot to live for.

“We first started to notice something was wrong when he suddenly started to fall over and also had trouble breathing. One night dad couldn’t breathe well and fell which led him being admitted to Sandwell Hospital.”

Paul said doctors found that his father (William) had metastatic spread from an undiagnosed cancerous tumour. This was complicated by large pleural effusions, for which chest drains were inserted and William was admitted onto a ward.

“At the time of dad’s admission, the team looking after him kept telling him that once the chest drains are done he could go home,” added Paul. “No one actually explained how serious the situation was and that there was little that could be done to change it. Instead, they kept giving him hope for a recovery and trying different treatments that were not making a difference. Dad, being a doctor, was also desperate to get well and wanted to try everything in order to get better.

“It was during the COVID restrictions and communication was difficult as we were not able to visit dad. In the meantime, numerous teams were visiting and assessing dad and going away without really telling him what was going on.

“It soon became clear that the team looking after him really did not know what to do – dad was dying and no one was acknowledging it.

“Things changed for the better when senior doctors realised dad was dying and made the decision to put him on the supportive care plan.

“Once dad was on the correct plan we were allowed to visit him and we could see a huge change in the way the team was treating him. They showed compassion and kindness to our entire family and did everything they could to ensure dad was able to be comfortable in his last days.

“From our point of view as a family whilst learning that dad was dying was extremely shocking, it helped take away the fear and angst that we had. As a doctor, when you avoid the conversation about death you take away the opportunity for people to say goodbye and prepare for what’s to come. As healthcare teams we must be brave enough to have these conversations with patients and their families as it’s part of our role.”

“While dad’s care was not always appropriate when he was first admitted to Sandwell, we were lucky that things changed for the better and we were allowed to say goodbye to him.”

Paul Turner concluded: “We miss dad dearly. He was an extraordinary man and had a chuckle that would send his grandchildren into streams of laughter. He loved people and was one of a kind. He was very special to me.”