Handling End-Of-Life Care With Compassion

Oakland Care believes in a personalised approach to care. We work closely with each resident to cater to their individual needs and preferences, even before they step through the doors of their chosen Oakland Care home, all the way through to when residents reach the end of their time with us – and beyond. 

One of the most difficult but important conversations to have with aging loved ones is how they would like to be cared for in their final months, weeks and days. Maryum Ahmad is the Manager at Woodland Grove care home in Loughton, also working as the end-of-life care lead.

During her time at Woodland Grove through the pandemic, she implemented the Gold Standards Framework (GSF) within her care home to help support her staff and residents. 

The Gold Standards Framework 

The Gold Standards Framework, or GSF, is an established charity which provides training for end-of-life care in care homes. It has been around for over 25 years and uses a color-coded staging system to categorise residents, and help staff to provide proactive care before residents pass away.

Woodland Grove has successfully achieved GSF accreditation, which now enables the Oakland Care home to provide hospice-level end-of-life care on site. Woodland Grove works closely with local hospitals, St. Clair’s Hospice, GPs, and other healthcare professionals to provide personalised end-of-life care for residents. 

The colour coding system categorises patients and residents, and indicates the stage of life they are in and what level of care they will need. From blue – which most residents arrive at – meaning they need some level of care but not end-of-life, to green, amber, red and finally purple. Red signifies the patient’s last days of life, with amber meaning the patient is deteriorating, green suggests a decline, instability, or advanced disease, and purple is used once the patient has passed.

During these colour coded stages, staff at the care home host regular structured MDT (Multi-Disciplinary Team) meetings ranging from monthly (green stage) to every 24-48 hours (red stage) to assess the patient’s prognosis. 

End-of-life care that doesn’t end there 

While end-of-life care often focuses on the resident requiring care, Maryum extends her support to the bereaved loved ones of those she cared for. She maintains regular bereavement support check-ins with families as part of the GSF purple stage and continues to call, send cards, and check in on surviving spouses and family members of passed residents during the festive period.

Oakland Care offer comprehensive support to grieving families, including paperwork assistance and funeral arrangement help, as well as regular on-going check ins and an Oakland Care bereavement pack with useful contact numbers. Often staff attend the funerals of residents they cared for, sometimes even on personal time, which shows the close family-like commitment to residents.

Helping to start the conversation 

One of the key parts of end-of-life care is opening up the conversation about what the resident wants the end of their life to look like and discussing this before they become unable to communicate their wishes to carers and loved ones.

Having the conversations early enables staff to personalise care to each resident and fulfil their wishes. Without prior discussion, best interest decisions become more difficult and uncertain for families and MDT teams in the home.

Maryum and her team take a comforting outlook on the process and discuss “how to live” rather than focusing on dying when discussing preferences for residents’ final days. 

The process begins during a pre-admission assessment to understand staging and needs of the resident. Some arrive with detailed advance directives, while others are reluctant to discuss the end-of-life process. Typically, the conversations are had pre-admission or initiated within the first few weeks after the resident moves in as part of their overall care plan, and begins with determining the length of stay (respite vs. permanent). 

Each discussion includes the family’s wishes as well as the resident, and all conversations are handled sensitively and subtly. Conversations include discussing the residents life history, their likes and dislikes, personal values and their individual personality.

Once this is established, GP involvement often precedes family discussions for guidance as well as their medical diagnosis is discussed, which leads to scenario planning and preference identification for end-of-life care. 

Maryum’s mission 

Maryum transitioned from residential care to nursing care, which required thorough end-of-life care training, and after the two-year GSF accreditation process, her perspective on death and dying had changed drastically.

Her ability to discuss death was enhanced by her new outlook, viewing death as an inevitable transition that requires proper care and support, with emphasis on maintaining a calm, caring and compassionate atmosphere in the home. 

If you or a loved one is struggling with discussing end-of-life care, or you have recently become bereaved, the National Bereavement Support Line is available for general grief support, and the Good Grief Trust is a recommended resource for bereaved families.

Oakland Care is committed to offering long-term support for both team members and families alike, and we will always advocate for end-of-life discussions to take place while people are young, healthy, and are able to advocate for themselves. 

If you would like to speak to anyone at Oakland Care about our end-of-life care services or bereavement support, contact our helpful team today. 

Listen to our full podcast with Maryum here.