Death as a Part of Life:
Planning/Preparing for the End of Life
No matter what your age, have you ever considered how you would want to be treated as you approached the end of your life?
Do you know what the wishes are of your loved ones and those whom you care for?
Many families probably never talk about death or dying. Sometimes they may even shut down conversations started by their elderly relatives as the subject feels too morbid or difficult to discuss. However, the evidence suggests that planning and preparing for a good death improves that time for both the patient and their family.
We understand that people need time to think about their wishes and preferences. As GP’s, we are trying to be more active in identifying patients who may be frail or suffer from medical conditions which affect both their quality of life and life expectancy.
It is our aim to enable our patients to experience comfort in their last phase of their life and part of this involves thinking about how, where and when they would want to be treated.
Your GP may have a conversation about your preferences, and possibly direct you to the weblinks below.
The aim of this is to make the discussion easier and more informed. It might prompt some people to start their own planning.
We encourage and invite discussions of this nature with you whenever you want.
Resuscitation Status:
In the UK, the default position of the emergency services that may be called to a patient when their heart or lungs have stopped working is to commence resuscitation.
Often a patient’s medical background is not available in these emergency situations.
In the case of people who have multiple health problems, or are frail, resuscitation is rarely successful, and it can be very traumatic not only for the patient but also for the family to witness.
It may be worth discussing whether this is what the patient and their family would want. If the patient has a DNAR form (Do Not Attempt Resuscitation) accessible to the emergency services, then resuscitation wouldn’t have to be attempted and nature could be allowed to take its course.
More information to guide your decision is below:
End of Life Planning – Treatments, Escalation Plans
https://www.nhs.uk/conditions/end-of-life-care/what-it-involves-and-when-it-starts/
https://www.dyingmatters.org/sites/default/files/preferred_priorities_for_care.pdf
https://withtheendinmind.co.uk
Support and Legal Elements (Lasting Power of Attorney and Wills)
https://www.ageuk.org.uk/information-advice/money-legal/end-of-life-planning/
https://www.alzheimers.org.uk/get-support/help-dementia-care/end-life-care
https://www.dorothyhouse.org.uk/making-a-will/lasting-power-of-attorney/
In Times of Death and Bereavement
Please see the attached leaflet explaining what to do if a family member or loved one dies at home and support services available
If Death Occurs at Home
1. Telephone the doctor or district nurse (if involved) who will visit to confirm that death has taken place and remove any syringe drivers or medications.
2. Contact a funeral director.
3. Arrange to collect the doctor’s Medical Certificate of Death (usually from the surgery) (during the COVID-19 pandemic, these are being emailed directly to the Registrar’s office)
4. Take this to the Registrar’s Office, (together with the deceased’s Medical Card and Birth Certificate, if available) for the area in which the death took place. Alternatively you can register by declaration at any convenient Registrar’s Office but certificates will not be available as these will have to be posted to you a few days later.
5. The Registrar will normally issue a Green coloured certificate for you to give to your funeral director who will look after necessary arrangements for the funeral. The Registrar will also issue a white notification certificate for the DSS. They will also enquire as to the number of Certified Copies you require for dealing with the deceased finances (a fee is payable for each copy).
If the Death Occurs in Hospital
1. Contact a funeral director to inform him his services are required.
2. Collect the certificate from the hospital then follow 4 – 5 as above
Note for Cremation
Your funeral director will usually liaise directly with the surgery regarding the additional certification required. During Covid 19 these forms are being emailed directly to the funeral directors.