good life, good death, good grief

Good Death Week blog

A Good Death in a Hospice?

In today's guest blog as part of #GoodDeathWeek, Kenny Steele, Chief Executive of Highland Hospice, talks about how organisations like his can help people to have a good death when the time comes...

What is a good death? ”I’ll tell you when I’ve experienced it” is the honest answer and since I feel reasonably hale and hearty as I write this, fingers crossed…. What I think might be a good death for me (totally unexpected and immediate) might be a terrible experience for those close to me (I think/hope!). Ever get the feeling you’re not going to get a straight answer?

What is easier to describe is what good care looks like, which can contribute to a better life before death and arguably a better experience of death for family and friends.

Describing what that best possible care would look like would be describing hospice care. There is no doubt in my mind that if you die or receive care in a hospice, you and your family will experience incredible levels of support and I know from the numbers of thank you letters and cards that we receive that families are incredibly appreciative of the work of our staff and volunteers. Often you will hear people talk about the feeling of relief, safety or sanctuary that they experience in hospice care.

So what makes hospices so special? The answer to this is complicated but I think can be summed up as:

1. It’s what we do. There are no other organisations in our community whose whole focus is on palliative and end of life care. This builds a positive culture and pride in getting it right and a huge amount of expertise amongst the team.

2. Community ownership. As a Chief Executive of a hospice I answer first to my community, before statutory bodies or regulators (although I do try to keep them happy as well!). However most of my funding and support comes from the local community which we serve. That helps to ensure that serving people remains the focus.

3. Money. We’re told it’s what makes the world go around and linked to the point above, the additional funding we receive through charitable donations is what enables us to remain entirely focussed on people’s needs and maintain a well resourced, compassionate team working in a wonderful environment.

So, is a hospice death the best death? Before we jump to that conclusion we need to consider how you end up in hospice care. The general criteria for admission to a hospice bed is that your physical and/or psychosocial symptoms are too complex to be managed in another setting. You may count yourself lucky to have a hospice bed available in such circumstances but unlucky to need a hospice bed in the first place. I therefore believe it is a false generalisation to suggest a hospice death is a better death than a death in another setting. Hospice in patient unit beds are however a highly valued and necessary resource in our community to support those with complex needs towards the end of life.

However, for me, the future of hospice does not necessarily mean more hospice care but rather the support of appropriate care toward the end of life in all settings. Highland Hospice supports some excellent care homes who we believe manage end of life care very well. They may struggle with some of the complex cases the hospice manages and their access to resources will be limited but they support their residents with great dignity and respect at the end of their lives.

I believe there is inherent compassion in our community and its various institutions towards supporting those with life shortening illness and experiencing bereavement. However for those of us not dealing with these issues on a regular basis it can be difficult to know what to do, what to say or how to offer support. This extends to the health and social care workforce as well. Everyone wants to do their best for those they are caring for and their families especially at end of life when there is only one chance to get it right. Much of the work of hospices going forward needs to be dedicated to supporting our compassionate communities so that as a society we can expect to have a good life and a good death in whichever setting is appropriate for us.

So, sorry to have swerved the question but here’s to a hale and hearty life and a society that supports you and me to experience a good death wherever that might be.

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Before I die I want to ...
Bereavement Charter for Scotland
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