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Palliative and End of Life Care:
Supporting Patient Choice
Salli Jeynes
CEO
The End of Life Partnership
Cheshire
‘We cannot take
away the whole hard
thing that is
happening, but we
can help the burden
into manageable
proportions’
Saunders, 1963
Some facts……
• Approx. 500,000 people die each year in England
• 1% of the English population dies each year, 75% of
these deaths are expected
• About 25% of all hospital beds are occupied by
someone who is dying
• More people are dying each year
• 100% of us will die
• Some people experience excellent care at the end of
their lives, many do not – inequities exist
• Care staff want the best possible experience for the
people they are supporting and caring for
People used to die young. Now they generally die old.
30
20
10
0
50
40
0-4 5-9y 10s 20s 30s 40s 50s 60s 70s 80+
age group/years
% of total deaths in different age groups. Data for the London parish of St
Botolph 1583-99, and for England & Wales 1998.
% of total
deaths
1590 1998
Death used to be acute. Now it is chronic.
Death rates in England & Wales (per 100,000)
Source: ONS 2004
Main causes
of death in
past:
Infections
Child birth
Heart
attack
Accident/Violence
Main causes of
death in
present:
Cancer
Heart failure
Stroke
COPD
http://www.cphs.mvm.ed.ac.uk/groups/ppcrg/themes_illnesses.php accessed 20/2/16
What people want at the end of life……..
National Voices
Survey 2011
Government response to Review of
Choice (2016)
• Honest discussions between health care
professionals and dying people
• Dying people making informed choices about their
care
• Personalised care plans for all
• The discussion of personalised care plans with care
professionals
• The involvement of families and carers in dying
people’s care
• A main contact so dying people know who to contact
at any time of day
Challenges – nothing new….??
• Staff stress and resilience
• More and more for less and less
• Self-compassion and care
• Thinking time for you
• Opportunity to reflect, question, share,
learn….
• Makes me think that…..
• Small measures/tips
• Common purpose
Some personal reflections……
Recognising dying….so important
Human kindness…in small and large measure….is
never forgotten
Listening to concerns of family….immeasurable
impact
“Is it OK with you if…?” “What do you think….?”
Simple things often meant the most…….

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Salli Jeynes

  • 1. Palliative and End of Life Care: Supporting Patient Choice Salli Jeynes CEO The End of Life Partnership Cheshire
  • 2. ‘We cannot take away the whole hard thing that is happening, but we can help the burden into manageable proportions’ Saunders, 1963
  • 3. Some facts…… • Approx. 500,000 people die each year in England • 1% of the English population dies each year, 75% of these deaths are expected • About 25% of all hospital beds are occupied by someone who is dying • More people are dying each year • 100% of us will die • Some people experience excellent care at the end of their lives, many do not – inequities exist • Care staff want the best possible experience for the people they are supporting and caring for
  • 4. People used to die young. Now they generally die old. 30 20 10 0 50 40 0-4 5-9y 10s 20s 30s 40s 50s 60s 70s 80+ age group/years % of total deaths in different age groups. Data for the London parish of St Botolph 1583-99, and for England & Wales 1998. % of total deaths 1590 1998
  • 5. Death used to be acute. Now it is chronic. Death rates in England & Wales (per 100,000) Source: ONS 2004 Main causes of death in past: Infections Child birth Heart attack Accident/Violence Main causes of death in present: Cancer Heart failure Stroke COPD
  • 7.
  • 8. What people want at the end of life…….. National Voices Survey 2011
  • 9. Government response to Review of Choice (2016) • Honest discussions between health care professionals and dying people • Dying people making informed choices about their care • Personalised care plans for all • The discussion of personalised care plans with care professionals • The involvement of families and carers in dying people’s care • A main contact so dying people know who to contact at any time of day
  • 11. • Staff stress and resilience • More and more for less and less • Self-compassion and care • Thinking time for you • Opportunity to reflect, question, share, learn…. • Makes me think that….. • Small measures/tips • Common purpose
  • 12. Some personal reflections…… Recognising dying….so important Human kindness…in small and large measure….is never forgotten Listening to concerns of family….immeasurable impact “Is it OK with you if…?” “What do you think….?” Simple things often meant the most…….