Towards a Good DeathCreating a compassionate community

Professor Edwin PughKeith Aungiers

Death and Dying is:

• a normal part of life

•more than a medical responsibility

• a Public Health and Societal Issue

• a responsibility of a ‘compassionate community’

Features of a compassionate community

• acknowledges end of life care as responsibility of wider community and organisations ….not just NHS

• involves end of life care in local government policy and planning

• offers people wide variety of supportive experiences, interactions and communication

• has strong commitment to social and cultural difference

What is a Good Death? A new vision for the north east

“The North East will have the highest quality services to support individuals (along with their families and carers) in their choices as they approach death.

By a good death we mean one which is free of pain, with family and friends nearby, with dignity and in the place of one’s choosing.”

Place and Preferences of the Public

• Place (Middlesbrough)

• 61% hospital • 21% home • 13% care home• 3% hospice

• Preferences

• 15%• 60%• 0%• 15%

The Challenge

• cultural shift in attitudes/behaviour takes years

• need to create a society where:

death is accepted as a ‘normal’ part of life

life goes on and has meaning and value even when person dying

society and individuals recognise responsibility to be compassionate to needs of those who are dying and their loved ones

policies and practice of all organisations sympathetic to needs of dying people

Better Health, Fairer Health ‘pledge’

• “We will create a charter for end of life care, with a statement of the rights and entitlements that should be honoured both for the individual preparing for death, and for their carers and families. This should relate not only to medical and nursing care but to the behaviours of all agencies and sectors who deal with these issues.”

Key to Success

• support by the public

• support by NHS, LAs, VCS

• ownership and backing by all agencies

• fit with NHS Constitution

Key elements of the charter

• Respect

• Time to plan

• Care

• Support

“Paradoxically the charter is not principally about dying - it is about living with dying and indeed ensuring we live to the fullest of our potential with meaning and value in whatever time we have.”

Examples of Action So Far

• Equity and Diversity

• Housing and Environment

• Human Resource policies

• The Faith Community

• Solicitors• Gateshead Council

• Home Group: Social Housing Provider

• Middlesbrough Council• NHS Organisations

• Teesside Interfaith Group• Orthodox Jewish Community• Churches regional commission

Compassionate Communities Unit

“It is neither desirable nor cost effective to see death as the province of clinical medicine. The new unit will implement the charter for A Good Death, stress the need to ‘normalise’ death, build public health capacity and aim to create a compassionate community approach to end of life.”

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I feel a Complete

wally

That Pugh is a wally I wish I

was dead

‘How people die remains in the memory of those who live on’Dame Cicely Saunders, Founder of the Hospice Movement