End of Life Care and Future Planning – Your Wishes

What is end of life care?

End of life care is usually described as being when the person is in their last year of life. Which may sound surprising given that we usually associate this phrase with being told that ‘nothing more can be done’. Which makes it seem as though the person’s imminent death is coming in days, weeks or months. 

The people we support often have long-term or chronic health conditions, which means they cannot be cured and will not get better. When treatment isn’t curable, it is usually referred to as ‘palliative care’, which precedes end of life care or can run alongside it.

What is an Advance Decision?

An advance decision is a decision a person can make now, to refuse a specific type of treatment at some point in the future (NHS.uk). It can also be referred to as an advance decision to refuse treatment (ADRT), or a living will.

The decision enables the person to clearly express their wishes and have this communicated to health professionals and family. It is a legal document that will clearly define which treatments the person is refusing and in what circumstances.

A copy of this document is usually held by the person, their GP, and by a health professional. It’s also included in our care plans for those we support. 

What is Future Planning?

The Rowans Hospice in Purbrook has provided end of life care and support for many years in the local area. Providing a  truly person-centred service both within the hospice, and support at home. They have produced a leaflet called Future Planning: Your Wishes. This leaflet is designed to help a person effectively document their thoughts and wishes concerning their care in the future.

The leaflet is given to your GP and, with your permission, can be shared with other heath care professionals via the Summary Care Record. This can assist emergency clinical staff in providing care to people anywhere in England.


For further information, click on the link www.futureplanning.org.uk/nextstep

How we train our staff

We have found that the best way to train our staff is to do so by the people that know best – the Rowans Hospice. Their team will undertake face to face training and go through the principles of end of life care. Including what to expect, how to communicate with the person and their relatives, and how the staff can look after themselves as well.

Our staff will always be given the option as to wether they wish to support the person at the end of their life. As we recognise that this type of care is not for everyone, so we carefully engage with our staff team to identify who is suitable and then offer training.

How it is all brought together

The information gained from the needs assessment about future planning or an advance decision will be detailed onto the person’s care plan. Which is then shared with the staff, so they will be fully aware of the person’s needs before they care for them. As the care progresses, the care plan will change to reflect it, often producing and specific end of life care plan.

We will speak to the person, their family and to other health care professionals as we move towards the last days or weeks to ensure we deliver the care in the way the person’s wants it. We do this at home, or, where able, will follow our service users into the hospital or hospice if this is their wish. 

In addition, we will arrange support meetings with health care professionals so that the staff are supported psychologically throughout, and after the process. Enabling them to participate in the care and beyond where able.