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|Lifecourse & End of Life |
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Lifecourse & End of Life

Understanding the immense changes in patterns of social, individual and community life continues to be one of the major roles and challenges for social science research.

People's lives and how they unfold over the Lifecourse in relation to education, employment, leisure, consumption and health are a topic of major national interest.

Demographic changes such as an increasing proportion of older people in the population (and a reducing retirement age) raise issues not only concerning social policy and employment, but also about participation, independence, and trust and responsibility between generations.

People's mental and physical health and their experience of health services are intimately related to social and lifestyle factors, and to expectations and aspirations

Presented the option, most people would choose to die at home surrounded by those whom they love. The latter may require support and resources to help them to cope. This can be a significant burden upon the Primary Healthcare Team in terms of time and emotion but it can also be most rewarding.

The Gold Standards Framework is supported by many authoritative bodies and represents a standard of excellence to which we should aspire. They summarize as their key tasks the 7 Cs: Communication, Co-ordination, Control of symptoms, Continuity including out of hours, continued learning, Career support, Care in the dying phase.

One of the key factors in managing terminal care is to institute such care at an appropriate time. This involves an estimation of prognosis. The Gold Standards Framework has developed a Prognostic Indicator Guide to assist in this process.

For the patient wishing to die at home there must be adequate backup. This usually means a close person such as a spouse, long-term partner, close relative or a team who are available 24 hours a day. The career must be prepared to cope with both the emotional and physical needs of the patient and these can both be very demanding.

Helping patients to face death begins at the point of diagnosis. In the not too distant past, it was the norm to keep patients in ignorance of a poor prognosis. Most clinicians would now agree that patients should be given as much information as possible, balancing truthfulness against psychological harm. In this age of patient autonomy, it is indeed unethical not to involve patients in decisions about their care.

Death will come to us all but when it becomes imminent; emotions are bound to be strong.

Fear is common. How long will it be? What will it be like?
Many people faced with death will turn to God either for the first time or as a return to lost faith.
They may also wish to make peace to end feuds with relatives or friends.
If a will has not been made, then even at this late stage it should be done as dying intestate almost invariably causes complications.

Death is not a failure of modern medicine but as inevitable as ever it was. "And one day, I too shall face death and not as a stranger.

References;

Priestley, M., 2003, Disability A life Course Approach. London; Blackwell Publishing Company.

Sugarman, L., 2004, Counselling and the Lifecourse. London; Sage Publications Ltd.

Esrcsocietytoday, 2010, Lifecourse Family and Generations. Retrieved 2 September from http://www.esrcsocietytoday.ac.uk/ESRCInfoCentre/research/LifecourseLifestylesHealth.
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