“Jenny lived with her husband and was referred to the Neighbourhood care team for end of life care and palliative care to manage her symptoms and keep her comfortable.
When I met Jenny and her husband, they told me that two years ago Jenny was told that she had end stage cancer and was given two weeks to live. But she was one of those amazing people who had defied the odds and was still going strong. Well maybe not so strong anymore. Her symptoms had worsened and it was clear that she was going to need support from the team. Jenny was aware that she was entering the end stage of her life.
Our team is unusual in that we are six community nurses and one health care assistant and together, we provide all the care for patients looked after by our GP practice. We are piloting a new approach to community care modelled on a similar approach in The Netherlands. We work closely the practice and Jenny’s doctor was committed to supporting her in any way possible.
On one occasion, I had an impromptu meeting on the hoof with the GP and the pharmacist. It was solid team working. The GP took a selfie of us and said it was ‘proper integrated working!’
Jenny was very clear from the beginning of our contact that she wanted to die at home. Her son in Cornwall had offered to have them come and stay with him, but they didn’t want that. In the end, her son at our suggestion was able to arrange a sabbatical from his job so that he could support his parents and be on hand.
Jenny’s care needs increased and our team visited her 4 x a day. We were able to increase her night support by having Marie Curie nurses to stay overnight. Everyone coped better when they were more rested.
We also worked closely with the St Joseph’s nurses but we called them Macmillan Nurses at Jenny’s request as she wanted to play down to connection to the hospice. Jenny’s symptoms were well managed. Many patients have a syringe driver to deliver medication continuously throughout the day, but Jenny was very comfortable with a subcutaneous delivery of medication.
It will sound strange to say but Jenny was happy, calm, content – and died peacefully with the people she loved around her.
The manner of her death was a satisfying for the team too as we felt that everything that needed to happen, did happen.
People have asked what support and debriefing is available for nurses who deal with these serious and complex situations. The answer is none apart from our care of each other. But for me it feels like the most natural thing to support someone in the final stage of life so it doesn’t feel like a sad event for us – but a privilege to be there alongside an individual and their family at a special time.”
Notes taken from a recording of community stories at a Tower Hamlets Together event on 5 October 2017. Names have been changed.