A New Type of Worker: Developing the End of Life Carer Dr Carol Purcell University of Hull 07/08/2018 Dr Carol Purcell

The Beginnings of the Project A chance meeting between the project leader and a manager of a care home led to discussions about end of life care Staff of the care home were reported to be unhappy when their residents were moved into acute hospital settings to die The manager wanted to enable residents to die in their own home - the care home 07/08/2018 Dr Carol Purcell

Context of the Project Growing awareness that people reaching the end of their life should be able to expect support and care to meet their physical, emotional, social and spiritual needs The report End of Life Care by the National Audit Office (2008) reported that the NHS and social care services are often not meeting the basic needs of people reaching the end of their life Department of Health (2008) End of Life Care Strategy : Promoting high quality care for all adults at the end of life DH: London 07/08/2018 Dr Carol Purcell

Contemporary Society and Dying Many people do not die as they would have wished, or in the place of their choice (their own home) Familiarity with death and dying has decreased Of the half a million people dying each year in in England, around 58% die in NHS hospitals Opportunities for training and greater openness and discussion about death and dying are needed (DH, 2008) 07/08/2018 Dr Carol Purcell

Aims of the Project To explore deficits in skills and knowledge that carers say they need to meet the physical, emotional, social and spiritual needs of the dying client To develop a learning programme to help carers bridge the identified skills and knowledge gap Dr Carol Purcell 07/08/2018

The Project Based in the workplace Only requirement for participants was a willingness to be open, to explore issues and discuss dying Focus groups allowed staff to investigate areas of workplace practice where they believed care could be improved through participation in a training programme The learning programme was constructed to meet the needs of the carer to support and provide appropriate interventions for the dying person 07/08/2018 Dr Carol Purcell

Programme Content Designed around: Carers/ client needs Emerging Common Core requirements for End of Life Care and Occupational Standards Content included: Palliative care and symptom management Physical comfort Complementary therapies Emotional wellbeing Improving communication Care pathways Mental Capacity Act 07/08/2018 Dr Carol Purcell

Findings 07/08/2018 Dr Carol Purcell

Carers self-rating of knowledge before and after learning programme 07/08/2018 Dr Carol Purcell

Carers self-rating of confidence before and after learning programme 07/08/2018 Dr Carol Purcell

New skills for example hand massage Benefits: Carers New skills for example hand massage 07/08/2018 Dr Carol Purcell

Benefits: Carers The knowledge to know what to do and who to talk to, to deal with the unexpected 07/08/2018 Dr Carol Purcell

Benefits: Carers Confidence to be able to talk with health care professionals at all levels when needed 07/08/2018 Dr Carol Purcell

Benefits: The Manager’s Perspective Success Contributed to achievement of Quality Delivery Gold Award New direction Dialogue with company to develop End of Life Care Unit New practices Improved client care Improved team work and staff satisfaction Improved communication Between care home and local GPs, PCT, District Nurses and the hospital 07/08/2018 Dr Carol Purcell

What do the carers who took part in the project want to tell us? “There is more to end of life care than I realised” “We talked about subjects which are usually overlooked and talked about very rarely” “I am more confident” “The best part has been my personal development” “My service users have benefitted as I am much more aware of their needs” “The training has had an enormous impact on all of us” 07/08/2018 Dr Carol Purcell

The Future: What we have learned from this project More End of Life Care training is needed Providing opportunities for open and frank exploration of difficult topics or issues through facilitated discussion groups is essential Workplace learning provides an opportunity for discussion of “real” issues; but learning at work is often disrupted due to client needs One of the most important factors in delivering good End of Life Care is the gaining of confidence through knowledge and skill development Dr Carol Purcell email: c.purcell@hull.ac.uk 07/08/2018 Dr Carol Purcell