News

Film and book of Philip Gould's final days released

 

Lord Gould's writing has now been published in a book, 'When I Die: Lessons from the Death Zone'. A film of the same name has also been released. The film, an intimate and moving portrait of Lord Gould's quest to find purpose and meaning in what he called 'The Death Zone', was shot by photographer and director Adrian Steirn, who spent two weeks filming their conservations.

http://www.youtube.com/watch?v=S2eUw0CUuMc&feature=player_embedded

At one point Lord Gould, who was diagnosed with cancer of the oesophagus in 2008 and given six months to live in summer 2011, says: "It is only when you are told you are going to die ... [that] life screams at you in its intensity."

He describes his final journey as "the most exciting and most extraordinary period" of his life and talks about having “more moments of happiness in the last five months than in the last few years".

"As long as I look death in the eye and as long as I accept that I can choose the death that I seek and the death that I choose I have some freedom. I have some power," he says.

"I have some possibility to shape for myself my own death and at that moment I have a kind of freedom."

Lord Gould's book 'When I die: Lessons from the Dead Zone', is described as 'courageous, profoundly moving and inspiring'. He writes about how he realised something he had never heard articulated before: death need not be only negative or painful, it can be life-affirming and revelatory. When Philip could no longer write, his daughter, Georgia, took over, writing the final chapter of the book.

 

Listen to Good Life, Good Death, Good Grief, on BBC Radio Scotland

Good Life, Good Death, Good Grief will be taking part in the "Call Kaye" programme on BBC Radio Scotland on Friday 6th April. The programme will feature a phone in about death, dying and bereavement in Scotand. The relevant part of the show will start at around 9.50 am. Why not call in and join the conversation?

Anticipatory Care Plans reduce inappropriate hospital admissions

A study in this month’s British Journal of General Practice found that more use of anticipatory care plans in primary care helped to reduce unplanned hospitalisations by 52%.

Surveys show that when asked, most people say they would prefer to die at home, yet most people die in hospital. Admitting someone to hospital when they are dying can often cause additional stress and discomfort to individuals and their families at a most distressing time. Not only are such inappropriate unplanned hospital admissions unwanted by individuals and their families, but they are also extremely costly and put stress on NHS systems. Thus, finding ways of enabling people to stay at home in the last days of their life gives individuals and families what they want, while saving the NHS considerable sums of money.

In this study efforts were made to focus the extended primary care team around patients at risk of admission to hospital, aiming to enable people to be cared for at home or in community settings, rather than being admitted to hospital. Identifying patients at high risk of admission to hospital, and providing them with supported choices around their possible future care options allows them to be more involved in making decisions.

Anticipatory care plans (ACP) are documents used to record discussions between patients and those involved in their care, regarding the patient’s future preferences for treatment and care. A person’s ACP includes information about that person’s wishes in the event of an expected deterioration in their health. With the patient’s consent, the plan can then be shared to ensure that their wishes regarding their final stages of care are widely known.

Dr Adrian Baker, a GP from Nairn, and his colleagues found that more use of ACPs in primary care helped reduce unplanned hospitalisations by 52% because more was understood regarding patients’ wishes surrounding medical interventions. ACPs did not affect the number of deaths of patients who took part in the study, compared to the control group, but the number of patients who died in hospital and the hospital bed days used in the last three months of life were significantly lower for those with an ACP, saving those patients from medical procedures they may not have wished to endure.

Dr Baker said: "Today’s NHS is all about patient choice, but few patients seem to understand the choices available to them in their final few months. Anticipatory care plans are a good way of looking at the options available with a view to ensuring that the wishes of loved ones are fully understood by everyone involved in their care so that unplanned hospitalisation can be avoided.

“We are faced with an ageing population, which is estimated to see 22 per cent of the population aged over 65 years by 2035. GPs have knowledge of a patient’s full medical history and often have a relationship based on trust. They are uniquely placed to broach this issue with the patient to help ensure their final wishes are met.”

 

Baker, A., Leak, P, Ritchie, L.D., Lee, A.J and Fielding, S. (2012) Anticipatory care planning and integration: a primary care pilot study aimed at reducing unplanned hospitalisation British Journal of General Practice, February 2012

 

At Good Life, Good Death, Good Grief we believe it is never too early to plan ahead, since planning for illness and death when you’re healthy means there is less to think about if you get sick. For more information about planning ahead see: planning for the future.

Margo MacDonald MSP proposes new Assisted Suicide Bill

Margo MacDonald, Independent MSP for the Lothians recently lodged a proposal for a Bill to legalise assisted suicide in Scotland. This move comes a year after a majority of Scottish Parliament members voted against her previous Bill on the issue.

MacDonald’s recent proposal is for “a Bill to enable a competent adult with a terminal illness or condition to request assistance to end their own life, and to decriminalise certain actions taken by others to provide such assistance.” There are several key differences between the new proposals and the previous proposals:

· the eligibility criteria are narrower

· a “pre-registration” form would be required

· there is no requirement for psychiatric assessment

· the proposal doesn’t include voluntary euthanasia

· written requests do not need to be witnessed

· there is no requirement for the presence or assistance of a physician, and a new role of “licensed facilitator” is suggested.

The consultation on these proposals runs until 30 March 2012, and all are welcome to comment. More information about the Bill is available on the Scottish Parliament website.

The Scottish Partnership for Palliative Care has produced a useful overview of the proposals, including a flowchart illustrating the proposed process for the provision of assistance to commit suicide.