Caring to the end

Christians in Care, an initiative of Pilgrims’ Friend Society, has been running end of life care training for our carers and those working across the care sector. Lucy Honeysett, a palliative care nurse and Lead Coordinator of Christians in Care, explain

Last year, I visited a dear friend who lived in a care home. She was well loved and well looked after but had deteriorated over several weeks and was now unconscious and in the final moments of life but didn’t seem settled. She was in pain, and it was very hard to see her like this. The carers were unsure what to do. Her pastor from her old church happened to be visiting at the same time and thankfully, in God’s timing, we were able to remain with her, holding her hand and reassuring her that we’d do all we could to help. We contacted the GP and nurse, and my friend was reassessed and given much needed pain relief. We prayed for her, and she seemed much more comfortable and peaceful before she died. I also did what I could to support the carers. But this visit stayed with me and added to a growing sense that there was a need for more end of life care training for carers.

"During this training, we covered the importance of good communication, planning ahead and exploring and recording people’s wishes."

Wonderfully, end of life care is a priority at Pilgrims’ Friend Society. Earlier this year, I contributed to the charity’s ongoing end of life care training at the Senior Carers’ Conference. During this training, we covered the importance of good communication, planning ahead and exploring and recording people’s wishes. We talked about resuscitation and how to spot the signs of deterioration, and also about responding to changing needs and caring for someone who is dying. We covered the importance of involving and supporting relatives, and of caring for ourselves and one another. It was a wonderful day, and I felt privileged to be with a group of experienced carers so committed to getting this right and doing the very best they can to care for ‘family members’ (as we call those who live with us) and their loved ones.

As well as supporting Pilgrims’ Friend Society staff, over the past year I have also delivered five end of life care training days on Zoom in my role at Christians in Care. These sessions were open to carers of all faiths and none.

Some thoughts about end of life

1. Talk about the end of life before you reach the end of life. Having early conversations, making and recording plans about what you want and don’t want helps ensure your voice is heard and care remains centred around your wishes.

2. If someone is for resuscitation, when their heart or lungs naturally stop working, a resuscitation attempt must be made, an ambulance called, and the person is transferred into hospital. If someone wants to die at home or in a care home, a ‘do not attempt cardiopulmonary resuscitation’ decision is needed. We used to call this form ‘Allow a natural death’ but now this decision is often recorded on a ReSPECT form (Recommended Summary Plan for Emergency Care and Treatment). This isn’t a form you or a loved one needs to sign, but one that a doctor or senior nurse completes that then helps guide the plan of care when someone is deteriorating and dies. You may need to ask for the important conversations needed to complete this form.

3. The suffering some people experience and witness at the end of life isn’t always physical. In fact, with advances in medicine, most physical suffering can be managed. God has made us more than physical beings. We are spiritual, relational, social, psychological people with hurts that medication cannot always soothe. Remaining present is powerful and conversations that bring peace and healing are important. Take time to say:

‘I’m sorry’, ‘I forgive you’, ‘Thank you’, ‘I will miss you’, ‘I love you’. And remember we can say this to loved ones who are too poorly to respond with words but can hear and be comforted. And we can invite God into moments like this. He draws near and by His Spirit, brings His love and grace that will comfort and redeem.

4. If you are worried about dying or concerned about a loved one who is dying, please talk to someone providing the care. Ask questions, ask for a review, ask for a reassessment if needed.

5. Remember that God will never leave us, never abandon us (Deuteronomy 31:8). Dying is an unknown journey we will all face. But it’s not unknown to God and when we’re in Christ, God promises to come with us. Jesus has gone ahead of us and will return to take us to be with Him (John14:1-4)and when we’re with Him in heaven, we’ll be more alive than we’ve ever been. What a precious thought!

End of Life Care Training

If you are a carer working in the care sector come and join an interactive, online session led by an experienced palliative care nurse.

Book your free place here