End of life care does not stop when the heart stops beating.
As a home manager, the care home I manage provides care for 57 people; 28 people who are living with dementia, and 29 younger people who are living with alcohol related brain damage.
Some of the residents do not have family members, through estrangement or because they have outlived their relatives and for these residents, relationships with the staff members are the closest to family that they have.
When a resident died, he was a few hundred pounds short of paying his funeral. As there was no family, there was no one to claim benefit or contribute to the cost and he ended up in a pauper’s grave with no marking to remind people of his life.
This was distressing for the care team. We discussed this within the team and it was decided that the care home should purchase a plot in the local graveyard where we could respectfully lay our residents to rest, with dignity.
Since then, the staff have arranged funerals for a number of residents, working with a local humanist (Paul Harkin). The service is planned and the memories of fellow residents and staff members are recorded, and form the basis of the memorial service. Staff members volunteer to be cord bearers for the coffin. By supporting staff and residents to remember their friend and to participate in the organisation of the service, they are able to grieve. It provides an outlet for their feelings and provides opportunities for other residents to think about their own funeral, how they would like to be laid to rest, what music they would like, etc. For some of them, they had never considered this an option.
Staff members select music to be played, and this is normally songs that held meaning for the resident. For one man it was Status Quo, ‘Rocking All Over the World’. For another it was Judy Garland, ‘Somewhere Over the Rainbow’, as this was from his favourite film.
The memorial service is then held in the care home. The staff members prepare the room and residents are supported to attend. When Paul delivers his service, very often there are not many dry eyes in the room. The hearse is brought to the care home and staff and residents follow to the graveside, where the committal takes place.
On the return to the care home, a purvey is provided and we sit together, as one, to talk about our memories of the person we have lost.
Life has many roads, and for some they get stuck on a path. This doesn’t mean that a person should not be afforded dignity at the end of their lives.
The Dash – Linda Ellis 1996
I read of a man who stood to speak
at the funeral of a friend
He referred to the date on his tombstone
from the beginning to the end
He noted that first came the date of his birth
and spoke the following date with tears
But he said what matters most of all
was the dash between the years
For the dash represents all the time
that he spent alive on earth
and only those who loved him
know what that little line is worth
For it matters not how much we own
the cars, the house, the cash
What matters is how we live and love
and how we spend our dash.
I’m privileged to spend my dash looking after others, ensuring that every day on earth is a day worth living, is a day where they are afforded dignity and respect. And when their life is coming to the end, they leave knowing that they are safe and that they will not face their final journey alone.
Alison McPherson (Hillview Care Home)
