Annex 9
CARE HOMES FOR OLDER PEOPLE: NATIONAL MINIMUM
STANDARDS
DYING AND
DEATH
The process of dying and death itself must never
be regarded as routine by managers and staff. The quality of the
care which residents receive in their last days is as important
as the quality of life which they experience prior to this. This
means that their physical and emotional needs must be met, their
comfort and well-being attended to and their wishes respected.
Pain and distress should be controlled and privacy and dignity
at all times preserved. The professional skills of palliative
care staff can help homes ensure the comfort of residents who
are dying. There are a number of specialist agencies providing
practical assistance and advice, such as Marie Curie and Macmillan
nurses, which can be called upon.
The impact of the death of a resident on the
community of residents may be significant and it is important
that the home ensures that opportunities are available for residents
to come to terms with it in ways which the individual residents
find comforting and acceptable. Thus opportunities for meditation
and reflection and for contact with local and religious and spiritual
leaders should be provided.
Residents should be encouraged to express their
wishes about what they want to happen when death approaches and
to provide instructions about the formalities to be observed after
they have died. Cultural and religious preferences must be observed.
There should also be an openness and willingness
on the part of staff to talk about dying and death and about those
residents who have recently died. Staff themselves, especially
young and inexperienced staff, may also need support at such times.
The needs of family and friends should also be attended to. Because
each individual will have their own preferences and expectations,
it is impossible to lay down standards for observances and practices
which can apply in every circumstance. However it is essential
for homes to have clear policies and procedures about how they
ensure that residents' last days are spent in comfort and dignity
and that their wishes are observed throughout.
DYING AND
DEATH (STANDARD)
Outcome
Service users are assured that at the time of
their death, staff will treat them and their family with care,
sensitivity and respect.
STANDARD 11
11.1 Care and comfort are given to
service users who are dying, their death is handled with dignity
and propriety, and their spiritual needs, rites and functions
observed.
11.2 Care staff make every effort to
ensure that the service user receives appropriate attention and
pain relief.
11.3 The service user's wishes concerning
terminal care and arrangements after death are discussed and carried
out.
11.4 The service user's family and
friends are involved (if that is what the service user wants)
in planning for and dealing with increasing infirmity, terminal
illness and death.
11.5 The privacy and dignity of the
service user who is dying are maintained at all times.
11.6 Service users are able to spend
their final days in their own rooms, surrounded by their personal
belongings, unless there are strong medical reasons to prevent
this.
11.7 The registered person ensures
that staff and service users who wish to offer comfort to a service
user who is dying are enabled and supported to do so.
11.8 Palliative care, practical assistance
and advice, and bereavement counselling are provided by trained
professionals /specialist agencies if the service user wishes.
11.9 The changing needs of service
users with deteriorating conditions or dementia—for personal
support or technical aids—are reviewed and met swiftly to
ensure the individual retains maximum control.
11.10 Relatives and friends of a service
user who is dying are able to stay with him/her, unless the service
user makes it clear that he or she does not want them to, for
as long as they wish.
11.11 The body of a service user who
has died is handled with dignity, and time is allowed for family
and friends to pay their respects.
11.12 Policies and procedures for handling
dying and death are in place and observed by staff.
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