Blog: Being in the right place to die

Have you thought about where you want to die? In this blog for Dying Matters Awareness Week, we are encouraging you to think about where would you like to be cared for and by who in the last months and days of your life. Prospect Hospice clinical nurse specialist Amanda Houston talks about being in the right place to die.

It’s a privilege to do my job supporting patients requiring end-of-life care.

When I meet patients for the first time I ask what is important to them. Everyone’s different and our approach at Prospect Hospice is to support patients holistically – their medical, emotional and spiritual needs – and we don’t judge them.

I work closely with other teams in the hospice – therapy, consultants and family support – so the care and support we offer is personalised.

The most important skill of a palliative care nurse is, I believe, to listen. Listen to what your patient wants, what are their wishes and what are their concerns.

It’s fair to say that sometimes when I talk to a new patient they are quite frightened when I say I’m from Prospect Hospice.  I feel people hear the word ‘hospice’ and often equate it with imminent death. In fact many patients generally feel better with hospice care as their comfort improves and symptoms are better managed.

It’s really important that I reassure them and gain their trust and confidence. I get to know them for who they are and the main thing I try to focus on is helping them to live well by supporting them and their families.

In my role I have to ask questions that sometimes patients find difficult to talk about, including dying.

One way of introducing the subject is to ask have they thought about their future plans should they deteriorate or as they become more unwell.

It’s important to open these conversations so I and my colleagues know what their plans are so we can support them.

I talk about the support we can offer them – whether this is at home or in the hospice – and how we will make their death as comfortable and peaceful as we can.

I describe the hospice to them; how wonderful the inpatient unit is, how positive the staff are and the beautiful gardens.

One patient I was supporting was terrified of dying. She came into the hospice for help with management of her symptoms. She got to know me and the team more while she was there and was reassured. We had an amazing conversation and she agreed that it would be nice for her to die in the hospice.

Many people’s preference is to die at home and we can support them with that. We can put things in place and we work with district nurses and care agencies to achieve it.

We get really lovely feedback from patients and their families. A husband of a patient who died at home thanked us. He said his wife was where she wanted to be and that gave him and his family comfort.

We don’t just support patients, our approach is about supporting their families as well. When a patient dies we will contact their family afterwards to ask how they are and if they would like bereavement support.

My job is a vocation and helping patients to be in the right place to die as they wish is such a privilege.

Amanda Houston is a clinical nurse specialist at Prospect Hospice. She supports patients who have advanced and life-limiting illnesses. She has been a nurse for 13 years and for the last 11 years has worked in palliative care.

 *For more information about referring yourself or a loved one to Prospect Hospice click here