Good Life Good Death Good Grief Mark Hazelwood Scottish Partnership for Palliative Care

Outline 1.Changes in death and dying in Scotland 2. Policy & practice response 3. A new alliance 4. A call to action

The projected percentage change in age structure of Scotland's population,

Living and Dying Well / GSF Framework

Where People Die in Scotland 2006 data Place of deathPercentage of deaths Hospice Care Home Hospital Home Estimated 81% of all deaths are at home

“palliatus” covered with a cloak

“Palliative Care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual” World Health Organisation 2004

Complementary Strands End of life care pathways Training & education 24/7 community nursing Access to equipment Anticipatory prescribing DNACPR Palliative care in care homes Palliative care in hospitals Public information Clinical guidelines Quality indicators

Dying Matters NatCen Survey Results (2009) 14 No -70% Have you discussed your wishes?

Why we don’t talk about dying 19% of men 16% of women Death is a long way off I am too young to think about it 47% of men 43% of women 20% of people over 75+ 3% of people over 75

“On neither the sun, nor death, can a man look fixedly.” Francois de La Rochefoucauld

Avoidable Harms Practical & financial problems from lack of wills Unnecessary fear of process of dying Not saying “good bye” or “I love you” Futile distressing medical interventions Lack of care planning Isolation of people who are very ill or bereaved

Who We Are Good Life, Good Death, Good Grief is an alliance of organisations and individuals Hosted and resourced by the Scottish Partnership for Palliative Care We aim to encourage greater openness about death, dying and bereavement To raise awareness of ways of living with these issues – those practical things which individuals and communities can do

But what do you actually do? Generate media coverage/national dialogue Identify & share good practice Provide ideas and tools Signpost to useful resource Influence government

“The First Minister is supportive of the Good Life, Good Death, Good Grief initiative and would wherever possible encourage people to take part in discussions about these topics which should help people in the future to deal with these very emotive issues.” Office of Alex Salmond MSP, First Minister

Call to Action! You can join now at Our website has ideas, suggestions and resources for you and your organisation

Resources & Acknowledgements Understanding patterns of health and social care at the end of life (Nuffield Trust, October 2012)Understanding patterns of health and social care at the end of life 5.Compassionate Cities; public health and end of life care - Allan Kellehear 6.A Social History of Dying – Alan Kellehear 7.Funeral Product Advertisement – From “Six Feet Under”, with thanks to HBO 8.Xbox Advert from Microsoft 9.Mark’s funeral music “Poses” by Rufus Wainwright