How to support clients at the end of their lives

Supporting clients who’ve been told they’re going to die can be extremely difficult. You have to help them navigate the news, put in place plans to support them, give reassurance during their final moments and start the necessary processes once a person passes away.

Helping people process the news that they’re dying

From experience, the news that someone you support and know well is going to die can come as a shock. Understandably, you’ve built a relationship with that person and would’ve likely developed a close bond with them. You have to process the emotions you’re feeling whilst remaining professional so you can support that person.

Allowing the person to process the news and ask questions is vital. It’s okay if you don’t know the answers, just be honest. What you can do is:

• Signpost them to services for information
  Here are some NHS resources you can share that go explain all the steps, from care options to making plans.
• Come back to them after doing some research
  Here’s some information from the NHS and an article by Hospice UK about what to expect when somebody is in the last few days of life.

As someone supporting people at the end of life, it’s important that you upskill yourself. There are several ways you can do this, including reading resources, undertaking end of life qualifications, attending courses, speaking with professionals etc. Improving your knowledge will allow you to better support someone but also prepare you for any emotions you may experience.

Putting plans in place to support them

Aside from the emotional support you’ll naturally give, it’s important to make sure the necessary preparatory steps are taken:

• Make sure care plans and risk assessments are updated and that line managers are aware if there are any changes to the person’s needs or if they require additional support.
• Ensure end of life care plans are implemented with the person and all professionals involved. It’s important that these are reviewed regularly and changed as required. It may be that the person wants to remain in their home, move into a care home, stay with family or go into a hospice. Whatever their decision, put the wheels in motion to fulfil their wishes.
• Arrangements are made for wills, funeral plans, DNACPRs, organ donations etc.
• If diagnosed at the hospital or by a specialist, ensure the person’s GP is informed.
• Source local provision, alternative therapies and services, and give the person an opportunity to access them, if they want to.
• Help communicate the news to family and friends, where required.
• Ensure faith and religion are taken into account and honoured.

Depending on which organisation you speak to and use, the end of life process may consist of different stages.

"It’s incredibly difficult supporting someone at the end of their life. You become part of their family and help ensure their final wishes are fulfilled – I truly believe it’s one of the biggest privileges you can have."

Supporting someone in their final moments

No two deaths will be the same, but there may be some common care needs, including:

• Ensuring the person is as comfortable as possible, with their wishes being met
• Managing pain by speaking to the person’s GP or specialists
• Being honest and sensitive in your communications
• Staying on top of oral care
• Reassuring the person, where needed
• Use of gentle touch (if the person agrees to this).

During the final days, you can spend time sitting (either talking or being there for comfort), reading a book, singing a song or sharing memories or experiences that you have.

It’s important that the person is left to rest if they wish and they are able to say goodbye to loved ones they request to see.

Caring for someone who’s dying can be physically and mentally draining. You could be working for long periods of time, supporting them and their families, so please do make sure you have some time for yourself and take advantage of break times and days off to recoup.

After somebody passes

Your organisation will have set policies and procedures in place for you to follow, but typically, the first thing you’ll need to do is call an ambulance or doctor to verify the death or make a referral to the coroner.

You can also be asked to:

• Wash and prepare the body
• Help arrange for equipment and medication to be returned or disposed of
• Ensure that the next of kin and/or funeral organisation have the person’s end of life plan so that they have the funeral arrangements they wanted.

Most importantly, you’ll support the family and your team to come to terms with the death, alongside managing your own emotions.

It’s up to you whether you stay in touch with the family if you’ve built a close relationship with them – after all, you would\ve spent a long time getting to know them. There’s no wrong or right answer, you have to do what’s best for you.

Many care workers will often attend the funeral, as a chance to say their final goodbyes and to show their respects. It may be that you don’t want to do this or you don’t feel this is appropriate and that’s okay too.

The impact on you

I want to end this blog by acknowledging how difficult it is to support someone at the end of their life. You become part of their family and help ensure their final wishes are fulfilled – I truly believe it’s one of the biggest privileges you can have.

But you need to take time to reflect on how you’re feeling. From experience, you may be wrapped up in the whole process of supporting a client and their family that you don’t stop to think what the impact the death has had on yourself.

So, I urge you to reach out to friends, colleagues and professional organisations to get support following a bereavement. After all, you need to give yourself just as much time as those you support.