DYING: TO START A CONSVERSATION “Living well – dying well” Chiltern Compass

Life is a gift, precious, to be savoured and enjoyed Life is a gift, precious, to be savoured and enjoyed. It comes with no guarantees except one: it is finite and will end at some time Chiltern Compass is here to help provide a direction that suits you, there is no one best route for everybody Talking about dying does not bring it any closer. This is not only about dying but living life to the full whilst you can The magic of doing this is that it frees you to live life in the present and to the full.

Dying remains a taboo subject for patients and GPs, says survey BMJ May 2012 Only 27% of public have spoken to a family member about dying and their wishes and only 8% written it down Only 37% have written a will 35% GPs have never initiated a discussion with their patients about end of life. Only 7% GPs have written down their own wishes and 53%written a will. Most of those surveyed saw the benefits of open discussions

Advantages of talking: ‘Home deaths were associated with both better bereavement response and better physical health post-bereavement than were inpatient deaths.’ Caregiver Bereavement Outcome: Relationship With Hospice at Home, Satisfaction With Care, and Home Death. Grande, Gunn E.;Farquhar, Morag C.;Barclay, Stephen I. G.;Todd, Chrs J. Journal of Palliative Care, Vol 20(2), 2004, 69-77.

Dame Cicely Saunders, founder of the hospice movement, said: "How people die remains in the memory of those who live on." Preparing a good death is possible, but only if one's wishes are known. There is only one chance to get it right.

Chiltern Compass: Who are we? Chiltern Compass is a charity based in Amersham and Chesham and serving much of the Chilterns. It is community orientated and aims to meet the needs of all ethnic groups and beliefs in preparation for end of life.   Chiltern Compass networks with other organisations involved in end of life care to provide as comprehensive advisory service as possible.  The team are a group of active and retired healthcare professionals and spiritual leaders who have recognised the need to address the issues in helping others in preparation for dying and organ donation. Other volunteers will support Chiltern Compass at events and promoting our objectives.

Our Objectives are: To encourage people to consider and talk through the issues, both practical and emotional, concerning the end of their lives. Talking with others often helps reduce stress and fear We plan to do this by: Organising workshops to provide a supportive and safe environment for people to discuss their worries and start planning. Visiting community organisations and societies to talk and encourage them to understand the issues and how to support each other. Doing presentations for professional and caring groups to help them communicate and address end of life issues for those they care for. Provide booklets and manuals as a frame work to guide people through the practicalities of preparing for the end of life.

End of Life Plan (sponsored by Paradigm) Finity Dr. Jo Withers End of Life Plan (sponsored by Paradigm) https://www.youtube.com/watch?v=8zOi6Z_0au8

How we die: Sudden Death occurs in 10% of the population Sudden illness such as cancer, resulting in death occurs in 25% A variable decline over months or years – organ failure in 30% Faltering decline over years – old age and dementia in 35%

Where do people die: Most (60-77%) people want to die at home. Yet most (58-80%) die in hospital. Of the remainder, 15-30% will die in an institution such as a nursing home

Practical Issues: Wills Lasting Power of Attorney Financial Health and Welfare Advance Directive Refusing treatment (ADRT) Organ donation (90% versus 29%) Body donation Funeral arrangements Bucket List

There are currently around 6,000 people on the UK Transplant Waiting List. Last year over 400 people died while waiting for a transplant.

Advantages: For yourself For your family For your carers For Medical and Nursing staff

Dylan Thomas Do not go gentle into that good night, Old age should burn and rave at close of day; Rage, rage against the dying of the light. - - - And you, my father, there on the sad height, 
 Curse, bless me now with your fierce tears, I pray. 
 Do not go gentle into that good night. Rage, rage against the dying of the light. Dylan Thomas

bryn_neal@doctors.org.uk chris.foote@btinternet.com